
COMMUNITY 
HYGIENE 



WOODS HUTCHINSON 




Class 
Book. 



Hji 



Copyright N°_ 



10 



COPYRIGHT DEPOSIT. 



THE WOODS HUTCHINSON HEALTH SERIES 



COMMUNITY HYGIENE 



BY 

WOODS HUTCHINSON, A. M., M. D. 
ii 

Sometime Professor of Anatomy, University of Iowa; Professor of Comparative 
Pathology and Methods of Scieiice Teaching, University of Buffalo; Lec- 
turer, London Medical Graduates' College and University of 
London; and State Health Officer of Oregon. Author of 
" Preventable Diseases,'' 1 "Conquest of Consump- 
tion.^ " Instinct and Health" etc. 




HOUGHTON MIFFLIN COMPANY 

BOSTON NEW YORK CHICAGO 



Revised Edition 



Y>. 






COPYRIGHT, I920, BY WOODS HUTCHINSON 
Copyright, 1916, by Woods Hutchinson 

ALL RIGHTS RESERVED 



Ninth Impression 
January, ig20 



.H 



BEfje fiibersfte |3res« 

CAMBRIDGE . MASSACHUSETTS 



JUN l2i92U 
•CU570309 



PREFACE 

One of the most significant and far-reaching 
movements of the day is the awakening of the 
health conscience of the community. No matter 
how alert, well informed, and prudent the individual 
may be, he is no longer able to protect his own 
health or that of his family from some of the most 
serious dangers which threaten it. Even the most 
wealthy and influential citizen is utterly powerless 
to insure the purity of his water-supply, the proper 
disposal of his sewage and garbage, the purity of 
the milk his children drink, or the wholesomeness 
of the food on his table, except by the aid of the 
strong arm of the law acting through public officers 
of health. In fact, health has become a community 
problem. 

At first sight, the wisdom of giving children in- 
formation about public health may seem open to 
question. They have no votes; and it will be several 
years before they are able either to influence public 
opinion or vote "yes" or "no" on questions of 
public sanitation. Furthermore, it may be argued 
that they are likely to have difficulty in understand- 
ing the engineering and chemical problems involved 
in public sanitary measures. 

These theoretical doubts, however, have little 
substantial foundation. While it is true that chil- 
dren have no votes, they are far from being unable 



iv PREFACE 

to influence public opinion. In fact, they are the 
most active and efficient teachers of their parents 
in particular and the community in general. "The 
wisdom of babes" has always had a high standing 
in history; and when children make up their inno- 
cent little minds that a certain line of hygienic con- 
duct is right and proper, the community is bound 
to be strongly influenced in that direction. 

Secondly, while some of the scientific principles 
involved are perhaps a little beyond their grasp, 
even when stated in the simplest way, the practical 
details of public health protection are a part of 
their everyday experiences, and are of direct interest 
to them. 

Thirdly, the earlier that children can learn to 
cooperate with one another, with their parents and 
teachers, and with the community at large for the 
promotion of the public health, the better. The 
youngest child can do something in this direction 
and the older children almost as much as adults. 

We are no longer satisfied merely to prevent dis- 
ease. We want to build up and actively increase the 
vigor, wholesomeness, and happiness of the com- 
munity. In this new and greater aim, it is even more 
important to have the cooperation of the children 
of the rising generation than that of the adult. 

Acknowledgment is due to Dr. B. E. Roberts, 
formerly Assistant Surgeon, United States Public 
Health Service, for his valuable assistance in the 
preparation of the revised edition. 



CONTENTS 

I. The Meaning of Health i 

II. Causes of Health 9 

III. Enemies to Health 17 

IV. The Kitchen 26 

Proper arrangement of kitchen — Cooking as a health 
factor — Our home sterilizer, the sink. 

V. The Pantry, the Ice-Box, and the Milk-House . 35 

Dry foods and their storage — Milk and the crops it 
grows — The free-delivery fly — Smells and their meaning. 

VI. The Cellar 44 

Why cellars are unwholesome — The change made by the 
furnace — How to store the family food-supply — The 
model cellar. 

VII. Washing and Laundering . . . . . . .51 

Cleanliness the price of life — Scrubbing floors, windows, 
and paint — Soaps and sodas — Why we launder clothes. 

VIII. The Bathroom 58 

The shower and the tub — Hot baths and cold — Pow- 
ders and creams — Towels and soaps — The internal bath. 

IX. The Furnace and Stoves 68 

Making our own climate — How to keep warm air fresh 
— How to keep air moist — Steam heat and furnaces. 

X. The Bedroom 74 

Need of ventilation — How our skins breathe — The 
proper kind of bed-clothes — Windows and walls. 

XI. The Living-Room, Play-Room, and Workshop . 83 

The furnishing of the living-room — Sweeping and dust- 
ing — Paper and paint — The children's play-room — The 
bench and tool-rack. 

XII. The Porches 94 

The healthiest room in the house ■ — Furnishings of the 
living-porch — The sleeping-porch — The back porch and 
summer kitchen. 



vi CONTENTS 

XIII. The Barn and the Outbuildings . . . .100 
The sanitary construction of the barn — Sanitary hen- 
houses and pigpens — The manure-heap, good servant but 
bad master — The drainage of the barnyard. 

XIV. The Lot and Garden no 

Arranging the house and garden healthfully — How to 

dispose of garbage — Waste water and the well. 

XV. Windows and Doors 121 

How to use our eyes — Why we need change of air. 

XVI. Heating and Ventilating 129 

Making our own heat — Second-hand air — The open- 
window classroom — The open-air classroom. 

XVII. The Desks and Blackboards 137 

Seats and desks that fit us — Posture and exercise — 

Blackboards, eye-strain, and dust. 

XVIII. Floors, Halls, Stairs, and Basements . . 143 
Floors and dust — Halls that waste space — Stairs that 

are easy to climb — The sanitary basement. 

XIX. Cloak-Rooms and Closets 150 

The sanitary toilet-room ■ — The school bath — The ster- 

ilizing-closet — Rest-rooms with cots. 

XX. Playgrounds and Shops 154 

The area of the playground — What we learn at play — 
What fatigue means — Where to play when it rains — The 
swimming-pool. 

XXI. The School Doctor and the School Nurse . 159 
The school clinic — Vacation schools in the country — 

When to report illness to the nurse or doctor — How dis- 
eases spread — The danger of towels. 

XXII. Pure-Food Laws and Food Inspection . . .170 
Why foods spoil — Keeping food clean in wagons and 

trains — The cold-storage warehouse — Inspecting foods 
in markets — Keeping food clean in shops — Inspecting 
bakeries, restaurants, and hotels — Food adulterations. 

XXIII. Pure Water and its Supply 183 

What happens to the rain before we drink it — City 

water supplies — How typhoid spreads — Other water- 
borne diseases — Home treatment of water. 



CONTENTS vii 

XXIV. Sewage and Garbage Disposal . . . .190 
Dangers of sewering into streams; into bays and harbors 

— Some methods of purifying sewage — Sewer-pipes and 
traps — Garbage-cans and carts — Garbage disposal. 

XXV. Street-Cleaning and Paving . . . . .199 
How dust gets into our systems — How dust is kept 

down — Pavements and health — Streets as playgrounds. 

XXVI'. Parks, Playgrounds, and Swimming-Pools . . 206 
Why the city spends money for parks — The park made 
for the people — Open-air lunch-rooms and cafes. 

XXVII. Houses and Streets 213 

Our right to a healthful and beautiful home — How 

houses become disease-breeders — Planning the city for 
health and beaut}' — Model dwellings and neighborhoods. 

XXVIII. Our Insect Enemies . . 220 

Disease-carrying insects — Food-eating insects — Fight- 
ing the mosquito and the fly — Rats, mice, and other vermin. 

XXIX. The Spread of Disease 233 

How we crowd one another to death — Quarantine, vac- 
cines, good housing — Keeping the neighborhood clean. 

XXX. The Great Causes of Death 246 

Mortality statistics — Heart disease — Tuberculosis, the 

Great White Plague — Pneumonia — Kidney disease — 
Cancer — Cerebral hemorrhage — Intestinal diseases of 
babies — Making a longer-lived and happier race. 

XXXI. Industrial Hygiene 251 

Making factories sanitary — Hours of work and fatigue 
— Ventilation and lighting of the shop ■ — Fire and accidents 

— Dangerous fumes, dusts, and lints — Lunch-rooms, rest- 
rooms, wash-rooms — Factory physician and nurse. 

XXXII. Traffic, Smoke, and Lighting . . . .268 
Safety first - — Rules of the road — Street -lighting and 

health — The smoke nuisance. 

XXXIII. How Children can help the Community . 279 
Growing up strong and well the best thing to do — Help- 
ing to keep the house healthful — The school health society 

— Reporting violations of health — Playground cleanliness. 

Setting-up Exercises 292 

Questions 293 

Glossary 311 



ILLUSTRATIONS 

Well-kept City „ . . „ . x 

Lesson in Mothercraft ..-..-'.... 7 

Street-cleaning . 1 1 

Way-Station for Germs 15 

Where City Children grow Strong . . . . .25 

Everything wrong in Kitchen 28 

Everything right in Kitchen .29 

A Simple but Attractive Dining-Room .... 34 

Everything wrong with Milkhouse 41 

How the City inspects Milk „ . .43 

Everything right in Bathroom 59 

Bedroom and Playroom 77 

Corner of Living-Room 85 

Health and Good Taste in Living-Room .... 89 

A Real Workshop 93 

How to sleep out of doors 97 

Wrong and Right Porches . 99 

A Disgrace to the City 109 

The Playhouse in 

Three Deadly Dangers . . . . . . . .115 

Ideal City Alley . . . . . . ., . . .117 

Nail-brush Drill in School 123 

The School Garden 127 

Preparing the School Lunch • , , . , . .134 



ILLUSTRATIONS ix 

Eating the School Lunch 135 

The Safe Kind of Door . 148 

Why Basements are dangerous 149 

Summer Camp and Vacation School . . . . =163 
School Nurse and Doctor at Work . . . . .167 

The Meat Inspector 173 

The Right Kind of Bakery 179 

Building a Good Road 201 

A City Play Street 205 

Civic Playground 211 

Their Only Place to play 215 

Baby's Summer Nap 229 

Saving the Babies 237 

Making Bad Citizens 253 

The Right Kind of Workroom ...... 257 

The Right Kind of Wash-Room ...... 262 

How a Factory feeds its Men 264 

Factory Doctor and Nurse 265 

Don't play on Car-Tracks . . . . . . . 273 

The Result of slipping between Cars .... 277 

A badly kept City 283 

Right and Wrong Laundries 287 

Rest Hour in a Detroit School . . e . . .291 




Courtesy W. H. Manning, Boston Courtesy Town Ro 

HOW TO RECOGNIZE A WELL-KEPT CITY 

Good pavements, good sidewalks, beautiful trees, gardens on vacant lots, a wad- 
ing-pool and a park where children can play, show a healthful community. 



COMMUNITY HYGIENE 

SECTION I - INTRODUCTION 

CHAPTER I 

THE MEANING OF HEALTH 

The naturalness of health. It is the most natural 
thing in the world to be healthy, and the easiest and 
pleasantest when you know how. In fact, one of 
the surest ways to be happy is to keep yourself 
and everybody around you healthy. To be healthy 
means simply to be clean, wholesome, and strong, 
able to do your share of the world's work cheerfully 
and well, and to lend a hand to others when you 
have a chance. 

Not only will health go far toward making you 
happy, but it is also your duty to keep yourself in 
health — -the athletes call it "keeping fit" — fit 
for work, fit for play, fit for duty and helpfulness, 
so that you will always be able to carry your share 
and never be a burden to your family or to the com- 
munity. It is really wrong to let yourself become 
sick or out of health when you can avoid it. 

There is nothing mysterious or hard to under- 
stand about health. It means being in such good 
condition that you are ready to meet anything that 
happens and conquer it. If you are well, you will 



2 COMMUNITY HYGIENE 

not only be able to do the ordinary, everyday, easy 
things well and promptly, but you will enjoy light- 
ing and conquering cold weather, disease germs, and 
exposure of all sorts. The very things which make 
you uncomfortable and wretched if you are feeble 
or sickly, will invigorate you, warm your blood, 
and give you the joy of conquering them if you 
are strong and well. 

The secret of health is to get the better of your 
surroundings and be master of your circumstances. 
The secret of ill health is to let them get the better 
of you. To be healthy, you must care for yourself 
as a good farmer does for his workhorses, or as a 
skillful engineer does for his engine. You must be 
well fed, well exercised, well rested, and well ven- 
tilated. It takes a great deal of work — either your 
own or your father's — to earn your food, house 
rent, and clothing, and to keep you strong and 
healthy; but when you learn to keep yourself well 
and take pride in doing so, it becomes one of the 
greatest pleasures in life. 

If you are healthy and well fed and work under 
healthy conditions, work is not a punishment, but 
an enjoyment. At first it may seem too much trou- 
ble to keep yourself spotlessly clean; to keep your 
hands washed, your hair parted, your teeth brushed, 
and your nails trimmed. But you feel so much 
better after you have done these things, and you 
thus avoid so much illness and discomfort, that they 
soon become second nature. You feel positively 



THE MEANING OF HEALTH 3 

unhappy and uncomfortable if you have lost your 
toothbrush, or can't have clean water to wash in, 
or must go without your bath. 

Health and happiness are first cousins. Many 
people think that it is a tiresome, melancholy, de- 
pressing thing to be thinking always about your 
health, to be afraid of catching diseases, refusing to 
eat this, forbidden to drink that, and living in con- 
stant fear that some disease may fasten itself upon 
you. So it may be, if you go about it in the wrong 
way. The fact is, however, that at least two thirds 
of the things you must do to keep yourself in health 
are things that you already like to do. You enjoy 
eating plenty of wholesome, nourishing, well-cooked 
food. You like plenty of play and exercise in the 
open air. You want to sleep ten hours every night 
in a warm, comfortable bed, in a pretty, well-lighted 
room with the windows wide open. You prefer to 
wear plain, light, comfortable clothing. 

Almost the only things that seem really difficult 
are keeping your hands respectably clean, especially 
at meal times ; keeping everything out of your mouth 
except food, drink, and a toothbrush ; keeping away 
from dirty or unwholesome things like undrained 
marshes, street mud, and the mouths of sewers; and 
having the windows open at the top in cold weather. 

If you keep doing vigorously and happily those 
things which make you well and strong, you won't 
need to worry much about the danger of becoming 
sick. Indeed, you won't have much time to spend 



4 COMMUNITY HYGIENE 

in worry. It is a good thing to know enough about 
diseases to know how to avoid them ; but if you will 
keep yourself well fed, well exercised, well rested, 
perfectly clean, and do not touch or come in contact 
with people who are sick, — unless they actually 
need your help, — you will avoid most of the risks 
that can be avoided. Keep the germs away from 
you, and just what their special names are need not 
bother you. All germs are alike so long as they have 
not crept inside your skin, or so long as you are 
strong enough to kill them if they start a small 
colony in your body. 

The money value of health. While we know that 
we cannot enjoy life or be of much use to others 
when we are out of health, we hardly realize what 
an exceedingly important and valuable thing health 
is to the whole community. We often speak of the 
great value of machinery, looms, mills, and fac- 
tories. We marvel at the strength of engines — - 
the wonderful weights they can lift and loads they 
can haul. Yet we seldom stop to think that the most 
wonderful and valuable "steam power" of all is 
the strength and skill of human bodies and brains. 

We boast of the wealth of our nation, of our rich 
and fertile farmlands, of our herds of cattle and 
flocks of sheep, of our splendid houses, factories, 
and shops, of our railroads with their thousands of 
engines and millions of cars and huge roundhouses 
and handsome stations, and the immense sums of 
money which all of these bring in every year. But 



THE MEANING OF HEALTH 5 

we forget that human labor earns more money for 
the nation every year than all these sources of 
wealth put together. The United States has more 
money invested in the health of men, women, and 
children — ■ will lose more by their sickness or weak- 
ness and gain more by their health and ' vigor — 
than in all of its other possessions put together. 
As a wise man expressed it years ago, "National 
health is national wealth." 

When a factory is burned down, or the boiler of 
an engine explodes and tears it to pieces, or two 
locomotives crash together and are smashed into 
scrap iron, we can easily see that the owners, and 
through them the community, have lost a great deal 
of money. But until recently we did not see so 
readily that the community also suffers a heavy 
money loss if a man, woman, or child dies, ten or 
twenty years before the natural end of life, of some 
disease which might have been prevented. This 
does not include the grief and the suffering which 
falls upon the family and friends. One is just as 
serious and genuine a loss as the other. It has been 
carefully calculated that every human life has a 
money value to the community, beginning with a 
newborn baby at three hundred dollars, and rising 
to a full-grown man or woman at six thousand dol- 
lars. It is encouraging to see that the value of 
human life is rising steadily. Thirty years ago it was 
estimated at only two thousand dollars for a full- 
grown man. 



6 COMMUNITY HYGIENE 

The community is now taking up seriously the 
question of disease prevention and the increase of 
health and vigor. Already it feels justified in spend- 
ing large sums of money to secure the conditions 
which produce health, working power, and hap- 
piness. Every year scores of new laws are passed 
by the different state legislatures and by Congress 
to secure pure and wholesome foods in shops and 
markets, to see that milk from our dairies is clean 
and wholesome, to bring an abundance of pure 
water to our cities and towns, sometimes from fifty 
or a hundred miles away in the mountains. 

The State has recognized that it is not only our 
business and our duty to keep healthy ourselves, 
but it is also our business to see that all others in 
the community, particularly children and women, 
shall be given a fair chance to keep themselves 
healthy and vigorous and happy. To permit any- 
thing else would be to allow a waste and destruction 
of our most valuable natural resources, which are 
far more important than mines or forests or water 
power. 

For instance, laws have been passed to compel 
all factories and shops and work-places to be kept 
clean and wholesome and well lighted and well ven- 
tilated; to install guards over dangerous machin- 
ery ; to prevent workers — particularly women and 
children — from working for such long hours as to 
injure their health; to provide lunch-rooms, rest- 
rooms, and toilet-rooms; and even to have doctors 



A LESSON IN MOTHERCRAFT 



8 COMMUNITY HYGIENE 

and nurses in attendance to treat accidents and ill- 
nesses which occur. Funds are provided for workers 
who become ill, and, if they are killed, to support 
and educate their families and children. 

This wonderful work is called Community Hy- 
giene. Even now we are approaching the point 
where, by taking intelligent care of ourselves and 
doing what we can to help others, we are able to 
prevent at least half of the ordinary diseases and ill 
health. When we are properly organized, we shall 
probably prevent three fourths of the sickness and 
early deaths which now occur. Think what that 
will mean for the welfare and happiness of the com- 
munity! As one probable result, we shall almost get 
rid of poverty. One of the ablest commissions that 
ever investigated the causes of poverty reported 
some years ago that in its judgment nearly two 
thirds of the poverty in the country was due to dis- 
ease and ill health. 

Then, let us keep ourselves healthy and do all 
that we can to help others to do the same. Let us 
get all the help and information we can which will 
teach us how to keep well and help others to keep 
well. By doing this, we shall make this world a com- 
fortable and happy place in which to live. 



CHAPTER II 

CAUSES OF HEALTH 

The prevalence of health. The causes of health 
are the causes of life — sunshine, food, air, and 
water. These are what the ancient Greeks called 
the four elements out of which the earth was made 
— fire, earth, air, and water. If we have plenty of 
fresh air and sunshine, plenty of good wholesome 
food, plenty of clean water to drink, and a fire to 
keep us warm in winter, we are more than likely to 
be healthy practically all of the time. Like the ma- 
gicians of old, who claimed that they could call 
spirits from the vasty deep, the earth, and the clouds 
to aid them, we can call all the forces of nature — 
the sun, the wind, the rain, and the brown earth — 
to help us keep healthy. The science which tells us 
how to do this is called Hygiene. 

In other words, health is a common thing, depend- 
ing upon common things. The individual who is 
well fed, well exercised, well rested, and well warmed, 
is healthy. The city that is clean, sunny, and has 
plenty of open spaces for grass to grow and children 
to play, is healthy. The individual who lets him- 
self be dirty, eats bad food, drinks impure water, 
breathes stale air, and works too hard without rest 
or play, becomes sick and makes others sick. The 



io COMMUNITY HYGIENE 

city with dirty streets, bad water-supply, crowded 
houses, insanitary markets and bakeshops, and 
smoke-filled air that shuts out the sun, will have a 
high rate of sickness and death. Health is just a 
matter of common sense applied to the common 
things of everyday life. 

We do not realize how common health is. So much 
disturbance is made about sickness, suffering, and 
death that we sometimes fancy disease is even more 
common than health. That is not true. 

A hundred years ago — indeed, even fifty — there 
was some excuse for such a mistaken idea. Science 
had not then taken charge of human affairs. Dirt 
was not known to be dangerous ; and nobody thought 
it had any connection with disease. People in Eu- 
rope and in this country did not know how to take 
care of their bodies, and did not know that many 
diseases could be prevented merely by keeping 
themselves, their food, water, and homes clean. 
Because they did not know, thousands of them died 
from diseases which we now know how to prevent, 
and the average length of life was only twenty 
years. 

To-day we know better. Any modern community 
would be ashamed to have the number of cases of 
disease that was common in the best communities 
fifty or a hundred years ago. The broom and the 
scrubbing-brush, the meat and vegetable inspector, 
the city chemist who makes sure that the city water- 
supply is pure, the garbage-collector, and the street- 



■ 




HOW OUR STREETS ARE KEPT CLEAN 



12 COMMUNITY HYGIENE 

cleaner — these are some of the civic agencies 
which have made our communities wholesome 
places in which to live. To-day we live on an aver- 
age nearly fifty-one years, chiefly because we know 
how to be clean. In India and China, where people 
have not learned how to take care of their bodies and 
homes, the average life is still about twenty years. 

It has been found in schools and factories that the 
number of days lost from sickness 'by each of us is 
about fifteen in a year, which means that we are 
healthy over twenty days for each day on which we 
are sick. That is a fairly good average ; but some day 
we are going to do even better. We are learning 
more and more all the time about how to keep our- 
selves well. 

How the Canal Zone was cleaned. What the 
community can do to make its citizens keep well 
was shown when the Panama Canal was built. 

The Canal was cut through the deadliest fever 
swamp in the world. It was considered that Panama 
had the most unhealthy climate known, except per- 
haps some parts of Africa. Every tropical infection 
known — malaria, yellow fever, the Black Death, 
cholera, and smallpox — could be found in Panama. 
In 1 88 1 the French Panama Company attempted 
to dig the Canal, and lost more than one tenth of its 
working force every year, or half of its men in five 
years. Conditions were very bad indeed — so bad 
that some people thought the Canal could never be 
built at all. 



CAUSES OF HEALTH 13 

Finally the French Company broke down and 
gave up the task and the United States undertook it. 

General Gorgas, head of the Panama Canal 
Health Commission, took hold of the health problem. 

One of the first things he did was to ask the 
United States Government to buy large quantities 
of the best and purest food to be found anywhere 
in this country. Beef was bought by the ton, flour 
by the carload, sugar by the thousand pounds, 
potatoes and fresh vegetables by the shipload. All 
these foods were shipped down to Panama to feed 
the engineers and laborers. At first the Government 
built restaurants and hotels and boarding-houses, 
because the workers, thinking they were coming to 
the most unhealthful country in the world, had not 
brought their families with them. After a time, when 
they found their health was so carefully protected, 
they sent for their families. Then the Government 
provided markets and shops where good food was 
sold at cost, and nowhere in the civilized world 
could food of the best quality be found at so low a 
price as in the Panama Canal Zone during the five 
years of the construction. This settled the clean food 
question, and laid the foundation for the rest of the 
health work. 

Putting in a pure water-supply. The next step 
that General Gorgas took was to stop the people 
from getting drinking-water from dirty or infected 
pools, sluggish streams, and stagnant swamps. He 
filled up all the shallow wells, because most of them 



14 COMMUNITY HYGIENE 

were infected with typhoid fever. He supplied 
every construction camp and working village along 
the line of the Canal with pure filtered water, cooled 
with absolutely pure artificial ice. 

This immediately stopped the typhoid fever, 
dysentery, and cholera which had caused thousands 
of deaths under the management of the French 
Company. At the same time he provided proper 
drains and sewers so that all the waste from the 
houses and shops was carried away and discharged 
into the rivers or the sea, where it could do no harm 
and could not infect the drinking-water. That was 
the second step in the health campaign. Those 
against malaria and yellow fever will be described 
in the next chapter. 

What happened to the death-rate. None of these 
steps which General Gorgas took sound exciting or 
unusual. Pure food, pure water, proper drainage — 
everybody knows about these things. In fact, they 
are only the very same steps which every town, city, 
and village in the United States has known for the 
last twenty years that it ought to take if it is going 
to be a wholesome place in which to live. 

What was the result? The death-rate in Panama 
in the old days before our Health Commission took 
charge had been from three to five times as great as 
that in the United States or Europe. The greater 
part of this frightful death-rate was caused by ma- 
laria, yellow fever, cholera, and typhoid, all of which 
diseases are especially bad in hot climates. The 



CAUSES OF HEALTH 15 




A WAY-STATION FOR GERMS 
The public drinking-cup is one of the busiest spreaders of disease germs known. 
If the big girl has a cold, what will happen to the baby if she drinks from the same 
cup? What if the big girl is coming down with scarlet fever? 

most striking thing which General Gorgas did was 
practically to wipe out all these diseases, partly by 
installing the pure water-supply, and partly by 
methods which we shall describe in the next chapter. 
He not only brought the death-rate to the same 
level as that of the United States (about fifteen 
deaths to every one thousand persons), but in the 
last three years of the Canal construction he made 
the Canal Zone the healthiest place in the civilized 
world, with a death-rate of five to six per thousand,, 
or scarcely one third that of the United States. 1 

1 It is only fair to say, however, that there was a much larger pro- 
portion of grown men and a smaller proportion of women and children 



16 COMMUNITY HYGIENE 

Contrast this with the conditions under the 
French Company, in 1881, when a death-rate of 
seventy-five to one hundred persons per thousand 
prevailed, and you will realize the result of keep- 
ing a community clean. It also shows how recent a 
thing is our knowledge of how to protect our health. 

Why Panama is a lesson to our communities. If 
General Gorgas could do what he did in the un- 
healthiest climate in the world, in a community 
which contained a large percentage of uneducated 
laborers, and with no civic improvements or civic 
pride to help him, what cannot intelligent American 
towns and cities do if they will only use their own 
good common sense to wipe out those things which 
cause disease and to increase those things which 
cause health? Our climate is naturally healthful, 
our homes are good, our citizens are intelligent and 
public-spirited. We can get pure water at compara- 
tively little cost, and good clean food without hav- 
ing to send it three thousand miles in refrigerator 
ships. We ought to be the healthiest nation in the 
world ; and if we will only do all that we know how 
to do and can do to keep ourselves well and help 
other people to do likewise, we can be much more 
healthy and happy than we are to-day. 

in Panama than in the United States, which would mean a smaller 
number of deaths, because more deaths occur during the first ten 
years of life than during any other period. 



CHAPTER III 

ENEMIES TO HEALTH 

Rocks in the life-stream. Much of our health 
knowledge is very old. We did not need, for in- 
stance, to wait for the discovery of the microscope 
or the invention of the steam engine to know that 
if people did not have enough food to eat, or ate 
spoiled food, they would become sick. In fact, we 
usually know by instinct what to do to keep well. 
We eat when we are hungry, drink when we are 
thirsty, and dislike muddy water in our glasses or 
dirty food on our plates. We dislike the taste of 
most poisonous things, without needing to be told 
that they are bad for us. We dislike the hot, burn- 
ing taste of alcohol, for instance, when we first try it. 
People who use it must teach themselves to like it, 
or even to swallow the wretched stuff without gasp- 
ing and making a face. 

Dangers which we do not know. Although we 
know by instinct a great many of the things which 
are bad for our health, there are other kinds of 
danger which we cannot understand unless we are 
told about them. These dangers have been dis- 
covered only in the last thirty or forty years, since 
the microscope came into use. They are the great 
diseases which run through a country, an army, or 



18 COMMUNITY HYGIENE 

a town ; and which are now called infections because 
they are " catching" and spread from one person 
to another "by touch." Sometimes they are called 
contagions from two Latin words which mean by 
touch, or spread by touch. Both these words mean 
that you catch the disease because something from 
the body or breath of a sick person has come in 
contact with your body. 

Most of these infections are fevers. When we 
have caught a fever infection, our bodies become 
hot, our faces turn red, our heads ache, and we say 
we feel " as if we were burning up." When a fever 
thermometer is slipped under our tongues, we find 
that our body heat, or temperature, has gone up 
from 98.6 to 100, 102, or even 105 degrees. It is no 
wonder we feel as if we were burning up, for we know 
that when the thermometer rises to 102 degrees in 
the shade we think it is a very hot day. 

Although these fevers or infections are trouble- 
some, and some of them are extremely dangerous, 
they usually " run their course " and come to an 
end of their own accord. They may make us feel 
very sick while they last, but we know that almost 
always the fever will " break " in a few days, the 
headache and backache disappear, we will feel much 
better, and will soon be well. 

For a long time people were greatly puzzled over 
the reason why these fevers behaved in this curious 
way. All of them, except the very worst, broke and 
began to improve sooner or later. Stranger still, 



ENEMIES TO HEALTH 19 

each particular fever or infection took a certain 
length of time to run its course, varying from three 
or four days for a common cold to three weeks for 
typhoid fever. 

Some fevers were even more peculiar; for while 
they ran for several weeks, or even months, they 
kept the patient sick only about half or a third of 
the time. These were the malarial fevers or agues — ■ 
or, as they were sometimes called, ' ' chills-and-fever, ' ' 
or " fever-and-ague." In some of these the patient 
one day was exceedingly ill and wretched, with a 
very high temperature and shaking until his teeth 
chattered. The next day he was practically well 
and able to go to work. The following day he came 
down with another chill and fever. This succession 
of fever and normal condition continued for weeks. 
The patient could tell with absolute certainty that 
on, say, Tuesday and Thursday and Saturday of 
next week, or the week after next, he would be very 
ill, and on Monday and Wednesday and Friday 
practically well. Some other kinds of malaria have 
a three-step instead of a two-step gait, making a 
patient sick one day, well two days, then sick again, 
then two days well. Still another has the habit of 
making the patient sick only two or three days out 
of the week, but gives him no idea in advance what 
days they will be. 

How we discovered the germ. This singular way 
the infections had of following their own peculiar 
course gave rise many centuries ago to the notion 



20 COMMUNITY HYGIENE 

that they were due to some kind of tiny plant or 
insect or worm which had made its way into the 
human body and was living its own life there. About 
fifty or sixty years ago we succeeded for the first 
time in making microscopes powerful enough to 
make such tiny objects visible. As soon as a drop 
of blood or saliva or other fluids from the body of a 
patient sick with these curious " living fevers " was 
placed under the microscope, we found that it was 
swarming with thousands of these tiny creatures. 
At first it was supposed that they were very small 
animals, but it was soon found that most of them 
were tiny plants, more like moulds and the fine, 
dusty powder in puff-balls than anything else. As 
these plants had never been seen before, they had 
no name; and they were christened germs, from a 
Latin word meaning seeds or sprouts. 

As one disease after another was studied, it was 
found that each of these infectious fevers was due to 
a special kind of germ ; that the length of time it took 
for the fever to get to its height was simply due to 
the length of time its germ needed to grow to its full 
size and numbers in the human body; and that the 
breaking and fall of the fever was due to the weaken- 
ing and death of the germs under the attack of the 
cells and fluids of the body. 

The same microscope which enabled us to see the 
germs also showed us that every part of our bodies 
was made up of an enormous number of tiny cells. 
In fact, our body cells and the germs which attack 



ENEMIES TO HEALTH 21 

them are much alike, only our body cells are from 
twenty to fifty times as big as the germs, and are 
animals, while most of the germs, as we have seen, 
are vegetables or plants. Another difference is that 
our body cells are tied together and packed closely 
side by side, like bricks in a house, or popcorn in a 
ball, while the germs are all separate and distinct 
from one another. Like fish in the sea, they swim 
about freely in all directions, in the blood or other 
fluids of the body. 

The battle between the cells and the germs is usu- 
ally all in our favor. The germs may be counted by 
thousands, or often by millions; but our body cells 
are numbered by billions, are far bigger and stronger, 
and have been trained for at least two or three 
thousand years to live on vegetables and eat germs 
of all sorts. Not only does the body destroy the dis- 
ease, germs which cause illness nineteen times out 
of every twenty, but it is almost certain that at 
least four out of five times that disease germs get 
into the body, the body destroys them before they 
have time to grow sufficiently numerous to cause 
an attack of the disease at all. In fact, even if we 
are exposed to the disease, we must either receive a 
very large dose of the germs, or be in a weakened 
and run-down condition in order to " catch it," as 
we say. 

How we avoid infections. Now that we know that; 
each one of these infections, from a cold in the head 
to consumption, and from chicken-pox to cholera. 



22 COMMUNITY HYGIENE 

is caused by a particular germ, and that this germ 
can come only from the body of some one who has 
that disease, it becomes a matter of common sense 
to try in every possible way to prevent the carrying 
of these germs from sick persons to well persons. 
Find out how the germs travel from one body to 
another and break the connection, and it will not 
be long before we shall get rid of these infectious 
diseases entirely. 

This power to break the connection between 
germs in the bodies of those who are sick and the 
bodies of those who are well has given us our great- 
est weapon for preventing disease and protecting 
health. In the previous chapter, we saw how Gen- 
eral Gorgas gave the people of the Canal Zone clean 
food, good drainage, and pure water. That did a 
great deal to stop sickness. Some diseases, such 
as cholera, typhoid, and dysentery, were carried 
chiefly through the water of streams or wells, which 
had been infected with the discharges from the 
bodies of patients suffering from cholera, or typhoid, 
or dysentery, and then was used for drinking water 
by others. Giving everybody plenty of pure water 
to drink and preventing them from drinking in- 
fected water stopped at once these three most deadly 
diseases. 

However, cleanliness alone was not enough to 
stop all the kinds of sickness, because the two dead- 
liest diseases at Panama were not carried directly 
from the body of one patient to that of another. 



ENEMIES TO HEALTH 23 

Malaria and yellow fever were carried by a certain 
kind of mosquito which sucked up the disease from 
the blood of a fever patient and later, in biting a 
well person, infected him with the disease. 

Clearly enough, the thing to do in this case was to 
destroy the mosquitoes, or to prevent them from 
biting the sick and becoming infected with the dis- 
ease, to infect, in turn, those who were well. This 
was done by draining the swamps where the mos- 
quitoes breed, screening all windows and doors of 
hospitals so that no mosquitoes could get at the 
sick people, and making the well employees live and 
sleep in houses which had been carefully screened. 

These three things were done so thoroughly that 
within two years General Gorgas was able to offer 
a reward of one hundred dollars for the discovery, 
in any hospital, house, hotel, or building in the 
Canal Zone, of a mosquito capable of carrying ma- 
laria or yellow fever. As a result of his campaign, 
these two dreaded diseases, which had formerly 
caused three fourths of all the deaths, practically 
disappeared. 

But there were two other serious diseases, pneu- 
monia (lung fever) and tuberculosis (consumption), 
which presented a different problem. They were 
due to germs ; but these germs could not pass from 
one body to another except when the sick and the 
well were crowded together in barracks or badly 
ventilated rooms. The houses were so well built 
and ventilated, and every one coming in was so 



24 COMMUNITY HYGIENE 

carefully examined for consumption, that the germs 
of consumption were never allowed to get a start 
in the Canal Zone. The germs of pneumonia, how- 
ever, have a curious habit of living on for months, 
and even years, in the mouths of those who have 
recovered from the disease, without producing the 
slightest effects upon their health. Many of the 
white men employed were carrying about pneu- 
monia germs in their mouths and throats. Much of 
the heavy labor on the Canal was done by negroes 
from the West Indies, and many of these had never 
been exposed to the disease. Therefore, when they 
lived or worked near the white men who were carry- 
ing the germs, they became violently ill. Being for 
the most part single men, or having left their fami- 
lies behind at home, they were housed in rather 
large and somewhat crowded barracks. The dis- 
ease spread among them at a fearful rate and caused 
a great many deaths during the first year or two. 
This, however, was soon stopped by encouraging 
the married men to send for their families and 
establishing them in well-built and well-screened 
cottages of their own. The unmarried men were 
distributed by twos and threes to board in these 
cottages. If a new man caught the disease, it did 
not spread because those in the cottage with him, 
having been there a year or more, had already been 
exposed to it ; and the pneumonia death-rate dropped 
to nearly as low a figure as that of Northern cities. 
You can see, then, that our health and that of 



ENEMIES TO HEALTH 25 




WHERE CITY CHILDREN GROW STRONG 

our communities, depends (1) on our natural knowl- 
edge of the things that are good for us, such as fresh 
air, sunshine, clean food, pure water, and wholesome 
work and play; (2) on our doing the things that we 
know will increase health and decrease disease, such 
as keeping our homes and our cities clean and 
wholesome ; and (3) in preventing the spread of dis- 
ease from one person to another, which is accom- 
plished partly by cleanliness, and partly by keeping 
well people — except doctors and nurses — • away 
from people who have been so unfortunate as to 
catch an infectious disease. 



SECTION II — HEALTH IN THE HOME 

CHAPTER IV 

THE KITCHEN 

" The heart of the kitchen " — the stove. From 
a health point of view, the kitchen is the most im- 
portant room in the house. It ought to be one of the 
most attractive — and indeed it is on baking days, 
as your nose will tell you. It should be one of the 
brightest, pleasantest, best ventilated, and abso- 
lutely the cleanest place in the house. Indeed, the 
picture made by its well-blacked stove with bright 
nickel trimmings, its snowy-topped table under the 
white-curtained window, its spotless floor, its glit- 
tering show of bright tins and blue-and- white china, 
its well-stocked pantry which smells of good things 
to eat, and its cabinet with shelves of fascinating 
glasses and jars, is much more attractive than the 
stiff front parlor. It is no mere accident that you 
find in the great picture galleries at least two or three 
times as many paintings of kitchens as of best 
parlors. 

The kitchen should be an attractive room, for 
here it is that our food is made interesting. Raw- 
food is just as nourishing as cooked food. Some of 
it tastes fairly appetizing — for example, apples and 
celery — but most of it has to be cooked before we 



THE KITCHEN 27 

like to eat it. Fancy sitting down to a meal of raw 
beef, raw potatoes, and dry corn-meal ! The kitchen 
is the cooking place, and the stove should occupy 
the position of honor. 

Instead of being set away in a corner, wherever 
the chimney and flue may be most conveniently put, 
it should be placed in the center of the longest wall 
in the room, and stand well out in the middle of the 
floor so that it will be only a few steps from it to any- 
thing else in the room. The oven door should face 
the window so that the cook may have a good light 
to see how the bread or roast is cooking. The sink 
should be at one side, not more than six or eight feet 
away, so that dishes and hot water may be quickly 
lifted backward and forward; and the table should 
be on the other side within easy reach, so that dishes 
which are to be cooked can be easily lifted from it 
to the stove or oven. The cabinet should stand 
directly over, or close beside, the table. Its shelves 
and drawers and swinging boxes for cooking mate- 
rials should be so arranged that they can be reached 
by the cook as she sits at the table, without rising 
or inconvenient reaching. 

Why and how we cook. If you were asked why 
we cook our food, you would probably say at once, 
" Because it tastes better." That is true, although 
it is only another way of saying that for thousands 
of years we have found cooked food agrees with us 
better, and so we have come to like the taste of it. 
Cooking makes food easier to digest, easier to chew 



28 



COMMUNITY HYGIENE 




Courtesy Mass. S.P.C.C. 

EVERYTHING WRONG IN A KITCHEN 

Dirt, umvholesomeness, bad ventilation, disorder, and lack of self-respect are 
plainly shown in the kitchen of this family. One would rather go hungry than eat 
a meal cooked here. 

or grind into a pulp, and kills any germs which may 
be in it. In some cases it will even destroy the poisons 
of germs, or other poisons, which may be in the 
food. 

Cooked food is not only much pleasanter, but 
also much more wholesome than uncooked food. 
It does n't. make much difference whether the heat 
is applied through boiling water, as in stewing or 
boiling; or through the walls of an oven, as in bak- 
ing; or directly to the food, as in broiling or frying, 



THE KITCHEN 



29 




EVERYTHING RIGHT IN A KITCHEN 

Cleanliness, light, air, order, and convenience of arrangement are shown in thifc 
kitchen. Notice the hood over the stove, the open plumbing, the washable walls, 
and the open window. - 



or toasting over the fire. If foods, such as vegetables 
or fruits, contain a great deal of moisture and we 
like to eat them moist, it is more convenient to boil 
or stew them. If we want to keep the juice and the 
water in our meat, we stew it with the vegetables; 
but if we want to bring out the real flavor of the 
meat, we broil or roast it. There is little saving in 
boiling meat because nearly all the weight lost in 
roasting or frying is water, which has no nutritive 
value; and as boiling takes a longer time than fry-* 



30 COMMUNITY HYGIENE 

ing or roasting, the extra cost of fuel more than 
balances the accidental waste caused by burning or 
cooking too hard on the edges. 

Our home sterilizer, the sink. Next after see- 
ing that the food is perfectly fresh and sweet when 
it comes and is kept scrupulously clean in a cool 
place until it is eaten, the most important care in 
a kitchen should be to keep all the pots, pans, and 
dishes in which food is cooked or served absolutely 
clean and sterile, or free from germs. If pots and 
pans are not carefully scrubbed and scoured, or if 
dishes are not thoroughly cleaned after use, the 
scraps of food which stick to them quickly begin to 
decay and will infect the next food which is placed 
in them. The best way to clean pans and dishes is 
first to scrape them with a dull knife, then to wash 
them or scrub them with a mop or brush in hot 
water to which has been added some soap or soda 
or other form of alkali, which has the power of dis- 
solving or "cutting" the grease. This first wash- 
water has all the dirt which was on the plates and 
dishes still dissolved in it, and when they are taken 
out there is still a thin film of grease over them. 
Now rinse them off by pouring hot water over them, 
or, better yet, while they are still warm, use a wire 
basket with a handle and dip them for a minute in 
clean boiling water. This not only makes them 
perfectly clean and sterile, but also saves a great 
deal of trouble in drying them. If the dishes are 
placed in a wire or wooden basket or rack, the last 



THE KITCHEN 31 

scalding rinsing leaves them so hot that they will 
almost dry by their own heat, and your dish-towel 
keeps clean and free from grease. It does not make 
much difference whether soap or soda or some one of 
the various washing-powders and cleansers is used 
in washing the dishes; only do not use any which are 
strong enough to "eat" the skin of your hands. 
Soap hurts the hands least. It is better to use a 
long-handled dish-mop so as to keep the hands en- 
tirely out of the first water, or to use rubber gloves 
when handling the glasses and silver. Any soaps or 
alkalies that are strong enough to dissolve the heavy 
grease on the dishes will irritate the skin of the 
hands, making it rough and chapped. Even very 
hot water, such as ought to be used for dish-water, 
has the same effect. 

It is not a mere matter of personal vanity to try 
to keep your hands smooth ; it is a matter of clean- 
liness. When your hands are rough and cracked, it 
is almost impossible to keep them perfectly clean, 
for dirt and germs will work into the cracks and stay 
there. Before each surgical operation, surgeons 
used to scrub their hands in six or seven different 
waters with strong germicides and soaps. They 
found, however, that after a few months this made 
the skin of their hands so rough and cracked that 
even after the most careful scrubbing germs were 
still on them when laboratory tests were made. 
They therefore gave up the scrubbings and scald- 
ings, used milder soaps, and wore rubber gloves. 



32 COMMUNITY HYGIENE 

If the skin of the hands is perfectly smooth and 
supple, it will shed germs and can be cleaned easily. 

Cleanliness in the kitchen. The kitchen ought to 
be kept almost as scrupulously clean and white as 
the surgery or operating-room in a hospital, because 
infection in the one place may be almost as danger- 
ous to health as in the other. Not a particle of food, 
waste, trimmings, or scraps should be left about to 
decay. The floor ought to be of hard wood. Some 
modern kitchens have floors of cement or colored 
tiles. Sometimes the floor may be covered with 
linoleum or heavy oilcloth. Whatever is used, it 
should be a material easily washed and kept clean. 
The walls should be well painted, with a glossy, 
hard finish, so that they can easily be wiped down 
with a damp cloth. A kitchen should be a corner 
room with windows in two sides of it, so that the 
heat of cooking and the odors of boiling cabbage or 
frying meat can be quickly carried away. It is also 
well to have a hood of sheet-iron or tin above the 
stove, opening into the chimney higher up, so that 
heat and cooking odors can be carried out by the 
chimney without scenting the whole house. No 
food should be kept in the kitchen itself, because 
the heat is almost certain to spoil it or cause it to 
give off unpleasant odors. Food should be kept in a 
closed pantry with outside windows, or in an ice- 
box or refrigerator. 

Light, air, and temperature in the kitchen. It is 
important to have windows in two sides of the 



THE KITCHEN 33 

kitchen for another reason besides ventilation and 
coolness. There should be light upon both sides of 
the stove, table, sink, and every corner of the room. 
Light is the best germicide and purifier known. 
Also, it is impossible to keep any place or corner 
clean unless there is plenty of light in it to show the 
dirt. Dark places always become dirty places sooner 
or later. While most women take pride in keeping 
every corner of the kitchen clean, some cooks are 
lazy and will not only leave dirt and dust lying un- 
touched in a dark corner, but will actually brush 
more into it, just to get it out of the way. There 
ought not to be any place in the kitchen in which 
dirt or dish-rags or floor-cloths or scrubbing-brushes 
can be hidden. 

Another reason for plenty of light and air in the 
kitchen is that there should be plenty of room to dry 
and ventilate the half-dozen or more dish-cloths and 
towels which should be scalded clean and dried 
every day. A dark, stuffy, ill-ventilated kitchen is 
a lurking place for dirt and germs. Sooner or later, 
they are sure to get into the food and cause trouble 
in our stomachs. 

Why a cook may look at a king. Some of the most 
important and useful work in the world is done in 
the kitchen. It calls for a high degree of skill, in- 
telligence, and care to do it wholesomely. It is as 
much a work of art to cook a good dinner or plan 
out a wholesome menu as it is to paint a picture or 
write a poem, and infinitely more useful and better 



34 COMMUNITY HYGIENE 




A SIMPLE BUT ATTRACTIVE DINING-ROOM 

Plenty of sun and fresh air, washable covers on the chairs, light draperies at'the 
windows, and a rug that can be taken out and swept — these are all excellent 
things to have in the room where we eat. 



worth doing. Cookery is one of the highest arts, 
and should be regarded as one of the most honorable 
and dignified occupations in the world. There are 
few people who are such useful members of society 
as really good cooks. 



CHAPTER V 

THE PANTRY, THE ICE-BOX, AND THE 
MILK-HOUSE 

How to keep food sweet. Most foods are change- 
able stuffs. They don't " keep " well. Vegetables 
and fruits lose water, wilt, and become unfit to eat. 
Flour and corn meal turn sour and moldy. Po- 
tatoes decay and sprout. Some foods, like milk, turn 
sour; or, like meat and eggs, become tainted; or, like 
butter, grow rancid. We can never avoid this risk in 
foods, no matter how carefully we may keep them, 
because this changeable condition is one of the 
things which make them fit for food. A food must 
be not merely a fuel, it must be a fuel in such a 
changeable form that it can be readily broken up 
and burned in the body. Fuels which keep extremely 
well are usually of little or no use in our bodies. 
Coal and wood and oil, for instance, are excellent 
fuels in a stove, but we could n't make a satisfying 
meal on them. We must, therefore, eat our foods as 
quickly as possible after they come from the farm 
or the garden, or we must keep them in places that 
will prevent as long as possible their undergoing 
these changes. 

Dry foods and their storage. Some foods, like 
flour, corn meal, rice, and sugar, need only to be 



36 COMMUNITY HYGIENE 

kept dry and free from dust or dirt. They car* 
easily be kept in boxes or bins or cans with tight- 
fitting tops. The main danger is that molds may 
get into them and cause them to spoil. Some of the 
changes which make foods unfit to eat come from 
the nature and structure of the foods themselves, 
and the easily changing form of them. But most of 
them, and all the serious ones, are caused by the 
growth in foods of certain germs or molds. Molds 
and yeasts are the commonest of these, because, un- 
like the disease germs, they give off tiny seeds or 
spores, which are so light that they float readily in 
the air, like grains of dust in a sunbeam. Almost all 
the air of rooms or houses, especially where foods 
have been stored or served, contains these floating 
spores of molds and yeasts. If food is left exposed 
to the air, these spores will sow themselves on it, and 
soon will grow a coat of blue, or gray, or whitish 
mold over its surface. Or, if it be moist and con- 
tain sugar, the yeast spores will fall into it, and it 
will begin to ferment. All boxes or cupboards or 
cans in which dry foods of any sort, particularly 
flour or bread or cake, have been kept, should be 
cleaned out very thoroughly at regular intervals and 
either scalded with boiling water or baked on the 
top of the stove to kill the germs. Better still, put 
them out in the sun where the sunlight can kill the 
germs. 

Moist foods and their care. Moist foods cause 
much more trouble. First, because ordinary drying 



THE PANTRY AND THE ICE-BOX 37 

or wilting tends to spoil them ; and second, because 
germs grow much faster upon wet surfaces, or upon 
moist substances, than they do on dry ones. The 
best thing that can be done with moist foods, like 
milk or meats or fruits or fresh vegetables, is to put 
them, in a cold place. In winter you may put them 
near an open window, or just outside it in a box 
covered with wire mesh. In warm weather, an ice- 
box is necessary. The cold keeps the food sweet by 
preventing the germs from growing. Unfortunately, 
however, there are some germs, like certain kinds of 
molds, which will grow even in a cold temperature. 
For this reason all the food should be taken out of 
the ice-box at least once a week, the shelves lifted 
out, and the inside of the box thoroughly scrubbed 
and scalded. If possible the shelves and the box 
itself should be put where the sun can shine into it 
for a while, or the ice-box will soon begin to smell 
sour from the growth of these molds. If it is not 
kept clean, food left in it for more than a day or so 
will become moldy. 

Milk and the crops it grows. Of all the moist 
foods, milk is the one which changes most rapidly. 
This is partly because it is almost as attractive to 
the germs as it is to us, and partly because it is in 
an easily changeable condition. Several germs will 
grow in it which can scarcely establish themselves 
in anything else. 

h As every one knows, milk, after a short time, 
turns sour. This is due to its infection with the germ 



38 COMMUNITY HYGIENE 

known as the lactic acid bacillus, which floats about 
through the air. Lactic is simply the Latin word for 
milky, and lactic acid bacillus means the milk sour 
germ. The acid produced by this germ curdles or 
" clabbers " the milk. After it has been curdled for 
some days, it begins to turn putrid. This is usually 
due to various dirt germs from the cow-barn, the 
milk-house where it was kept, or from the dust of 
the street, if it was ladled out of cans in the milk- 
wagon. 

How to keep milk sweet. Milk as it comes from 
the cow is usually perfectly pure and wholesome. 
If pains are taken to keep it free from germs, it will 
keep sweet and fresh in a cool place, not merely for 
one or two days, but even for ten days or two weeks. 
This, however, is impossible unless the barn or shed 
where the cows are milked is kept clean and free 
from dust, and is floored with cement or some other 
waterproof material which can be washed down 
with the hose. The milkers must wash their hands 
carefully before they begin to milk, and must put 
on clean cotton caps and jackets. The milk must 
be cooled and put at once into bottles with close- 
fitting tops. As most city milk is from twenty-four 
to sixty hours old before it reaches the consumer, it 
is most important that all germs should be kept out 
of it; otherwise, in this length of time they would 
have grown to such enormous numbers that the 
milk would be unwholesome to drink. 

In the country, and in villages or small towns, 



THE PANTRY AND THE ICE-BOX 39 

where the milk can be used within ten or fifteen 
hours after milking, it may not become so unwhole- 
some even if a little of this barn dirts gets into it, 
because the germs have not had time to increase to 
such enormous numbers. But nobody likes the idea 
of drinking milk that is not clean. Besides, some of 
the milkers or handlers may have had typhoid fever 
and still may be carrying the germs of it in their 
bodies. Unless they are very careful to wash their 
hands, some of these germs may get into the milk. 
Scarlet fever may also be carried in the same way. 

Our acid friend. In one sense, curiously enough, 
we hardly ought to regard the lactic acid or milk 
sour bacillus as an enemy, because if milk is care- 
lessly handled so that it contains dirt germs, the 
acid produced by the lactic acid bacillus prevents 
these germs of putrefaction from developing for 
twelve or fifteen hours and sometimes for a day or 
two. Sour milk, though usually unpleasant to the 
taste, is not actually unwholesome, except for 
young babies or invalids. Many people in hot 
countries, like the Kaffirs of Central Africa, de- 
liberately curdle their milk soon after it comes 
from the cow by putting a little sour milk into it. 
This turns it sour quickly, and prevents the develop- 
ment of the germs of decay. 

Milk-pantries and milk-houses. After the milk 
has been carried in pails from the barn into the milk- 
house or spring-house or pantry, the most impor- 
tant thing to do is to keep it carefully protected from 



4 o COMMUNITY HYGIENE 

dust or flies so that no more germs can possibly get 
into it. Also it must be kept as cool as possible, to 
check or prevent the growth of such germs as may 
already be in it. This is why the old-fashioned milk- 
house was often built over a spring, so that the 
milk-pans could stand in a trough full of the cool 
spring water which was kept flowing through it. If 
there was no spring, they were placed near a well 
and a pipe arranged so that water could be pumped 
into the troughs and changed frequently. These 
milk-houses or pantries should be kept spotlessly 
clean and so arranged that they can be thrown open 
once or twice a week for a thorough airing and sun- 
ning. All doors and windows should be carefully 
screened with the finest and closest wire mesh, so as 
to keep out not only flies and other larger insects, 
but dust and midges. If ice can be had, it is much 
better, of course, to shut the milk into an ice-box; 
but if cold water can be had in such quantity as to 
keep the temperature of the milk down to fifty-five 
degrees or lower, this will do very well. 

The free-delivery fly. The busiest and most 
effective distributor of germs and dirt over our food 
is the ordinary house fly. All you have to do in 
summer time is to leave food where the flies can get 
at it, and you can count on its being infected within 
three minutes. The fly lives on food and he breeds 
in filth — ■ manure heaps, garbage piles, and the like 
— and he keeps up a constant circulation between 
the two. If any garbage, offal, dirt, manure, or 




* 






/ 



42 COMMUNITY HYGIENE 

other decaying substances are left within a hundred 
yards of your house, you can be sure that it will be 
found by the fly, and that he will carry samples of it 
back to your food. The best way to keep flies out of 
the pantry is to have no flies. Until that victory is 
won, and for fear your neighbors might not keep 
all their flies at home, it is safest to see that at 
least all the windows and doors in the kitchen, pan- 
try, dining-room, and cellar are covered with well- 
fitting wire screens. Every screen that you put in 
the house will save at least one attack of stomach 
or bowel trouble for each member of the family. 

Smells and their meaning. One of the best ways 
to tell whether a pantry is being kept properly 
clean and well ventilated, and whether the food is 
properly protected and cooled, is to go into it fresh 
from out of doors, sniff hard, and notice how it 
smells. If it smells cool, fresh, and clean, and if the 
only odors you can distinguish are those of the 
different kinds of foods, you may feel sure that 
everything is in good condition. Nature warns us 
against decaying and unwholesome foods by the 
unpleasant odors of most processes of fermentation 
and putrefaction. The fermentations caused by the 
yeast plant when stewed fruits or jam or bread turn 
sour generally have a pungent, sourish, vinegary 
smell. Those caused by molds and musts give off 
a mousy, musty odor. Those changes caused by the 
germs of putrefaction and ordinary dirt have a 
tainted, disagreeable smell, easy to recognize. 




HOW THE CITY INSPECTS OUR MILK 

The city milk inspector testing can-delivered milk as it comes into the city 
in the early morning, and the bottling room of a sanitary dairy. 



CHAPTER VI 

THE CELLAR 

Cave dwellings of to-day. The old-fashioned 
cellar was a survival of the earliest house, which 
was a hole in the ground. The protection and 
warmth afforded to ©ur ancestors by their cave 
dwellings were advantages which they could get in 
no other way. These advantages still exist, but 
modern methods of storage and heating make them 
much less important to us, and the disadvantages 
of the cellar's darkness, dampness, and mustiness 
far outweigh its good qualities. It may be easy 
to heat without much cost for fuel, but it is hard 
to light, harder to ventilate, and hardest of all to 
drain. 

There are good reasons, however, for our con- 
tinuing to dig cellars, in spite of their disadvantages. 
A well-heated and properly drained cellar helps to 
keep the floor of the house dry and warm. The best 
place for the furnace is in the cellar, and coal must 
be stored somewhere close by. Besides, the cellar is 
a convenient place to store tools, canned goods, and 
such household supplies as are not subject to decay 
or mold. 

Why cellars are unwholesome. Up to twenty 
years ago, and even to-day in many rural com- 



THE CELLAR 45 

munities, the cellar was used to store the greater 
part of the family's winter food-supply, and many 
foods throughout the year. It was dark, damp, 
and musty. Like nearly all dark places, it was 
dirty. It was perfumed by the ghosts of ancient 
cabbages, decaying turnips, pickle barrels, and salt 
meat. Its moisture and darkness made it a breeding- 
ground for molds and yeasts of every description. 
Almost everything left in it, from fruits and vege- 
tables to salt meat and milk, was likely to become 
coated with a greenish or grayish covering of mold, 
or soured by the fermenting growth of yeasts. The 
pickle barrels grew sourer little by little through 
the winter, the bins of vegetables gradually became 
more and more decayed, and milk, cream, or cheese 
was apt to sour very quickly in the contaminated 
air. By spring, the cellar was in a most insanitary 
and unwholesome condition, and the odors given off 
from it rose through the floor and up the stairway 
to scent the whole house. 

Worse than that, it was damp. While the surface 
of the ground about the house might be sloped 
and graded for drainage, and perhaps might have 
a tile drain laid down, this drainage system was 
considerably above the floor of the cellar. Conse- 
quently, water collected, so that at times one had 
to balance one's uncertain way upon boards sup- 
ported on boxes or buckets across the cellar floor 
to the food shelves. Living over a damp, stagnant 
place of this kind is bad for the health of the family. 



46 COMMUNITY HYGIENE 

Chilblains, colds, and various infections are likely to 
result, and the health average of the family is always 
lowered. 

The flora and fauna of the cellar. Another of the 
serious disadvantages of the old-fashioned cellar 
was its animal and vegetable inhabitants. Not only 
were cellars a hothouse for molds, yeasts, and all 
sorts of bacteria, but they were havens of refuge for 
rats, mice, cockroaches, earwigs, beetles, and even 
small newts and salamanders. In the autumn, rats 
and mice swarmed into the cellar, and set up house- 
keeping. They ate what fruits and vegetables they 
could, scampered over and gnawed the rest at 
leisure, and enjoyed themselves thoroughly. They 
scratched holes in the dirt under the board floor and 
dragged fragments of food into dark corners, where 
they left them to decay. Not only did they waste 
ten times as much food as they ate, but they were 
a menace to public health. Rats carry bubonic 
plague. Both mice and rats are .filthy in their hab- 
its and may carry germs from filth to our food. 
They are dirt-making, disease-spreading vermin, 
and the modern house and cellar should be built so 
that there is absolutely not a single nook or corner 
in which they can live, or through which they can 
penetrate into the house. 

The change made by the furnace. Except in a 
few old houses, the coming of the furnace has 
changed this unwholesome condition of the cellar. 
Most modern cellars are built as basements, rising 



THE CELLAR 47 

at least two feet above the ground on their deepest 
side, and often being almost at ground level at 
their shallowest end. They are much easier to 
light, ventilate, and drain, and are far more whole- 
some. 

The furnace has done another thing in the interests 
of health by making the cellar a poor place to store 
food. It has made the cellar so dry that most fruits 
and vegetables are apt to shrivel if kept too long in 
it, and has thereby broken the old custom of piling 
bushels of apples, potatoes, cabbages, turnips, and 
other vegetables into the cellar in the fall, to be 
eaten all through the winter as they gradually de- 
cay. It has also stopped the unwholesome custom 
of pickling in barrels, or dry-salting upon cellar 
shelves, of a considerable amount of the winter's 
beef and pork; and it has made the cellar the last 
place where the housewife tries to keep milk, cream, 
butter, and cheese. 

How to store the family food-supply. As we have 
seen, the cellar is a poor place in which to store 
food products. Still, there are many foods which 
can be bought in quantity much more cheaply than 
by the quarter's- worth ; and on the farm it is ab- 
solutely necessary to store the home-grown supply 
of vegetables, fruits, meat, and milk. What, then, 
should be done with it? 

Where milk is handled in considerable quantities, 
a milk-house with water flowing through it should 
be provided. This is described on page 40. In 



48 COMMUNITY HYGIENE 

towns and cities, the only proper place to keep milk, 
cream, butter, and cheese is in the ice-box. 

Where people are fortunate enough to grow their 
own fruit and vegetables, it is a good investment to 
build a special storehouse. This both protects the 
health of the family, and saves waste through decay. 
It may be in the form of a cave with the roof cov- 
ered with earth and a provision for ventilation made 
at each end; or, better still, of rough lumber with 
thick double walls, the space between them being- 
filled with dry sawdust or hay. Fruit and vege- 
tables will stand a great deal of cold, provided the 
freezing or thawing is not too sudden. With the 
assistance of a small coal-oil stove, which can be 
lighted on the coldest nights, apples, potatoes, and 
other vegetables can be kept in far better condition 
in such a storehouse than in damp cellars. 

Where the household cures its own meat, a small 
and comparatively inexpensive but tight and well- 
built shed or smokehouse should be used for this 
purpose, with good light and ventilation and screens 
over doors and windows. Properly cured and 
smoked meats are not hurt in the least by being 
frozen, and there is no reason why meat curing and 
meat storage should be carried on in the cellar. 
From the point of view of the family's health, there 
is every reason why they should not be permitted 
there. 

In some cases, however, it may be necessary to 
use the cellar as a storehouse for foods, and if the 



THE CELLAR 49 

storage is properly managed, this may be done 
without serious danger to health. 

The best method is to set off one particular room 
for the purpose. It should be well lighted, well 
drained, and may, if desired, have a double wall, 
filled with sawdust. By adjusting the openings of 
the well-screened windows, it can be kept cool in 
winter, even when the furnace is being operated. 
Apples, potatoes, celery, winter squashes, etc., can 
be kept in excellent condition if laid on racks or 
shelves in such a room. They should be piled only 
one layer deep, and kept in a good light, so that 
they can be watched constantly for signs of decay. 
Milk, butter, and cheese should not be kept in 
basement rooms, no matter how carefully arranged, 
on account of the extreme readiness with which they 
absorb odors and sprout any bacteria or molds 
which may be floating in the air. Neither should 
pickle barrels be allowed. Dry-salted meats, if kept 
on racks similar to those used for the vegetables, 
may be stored in the basement, and of course canned 
goods and preserved fruits, jellies, and jams her- 
metically sealed in glass jars can be kept in the 
basement without spoiling and without injuring the 
family health. 

How the model cellar should be made. The model 
cellar or basement, as constructed by boards of 
health fighting the plague and other diseases, has 
cement walls, cement floors, and a broad strip of 
wire mesh buried in the cement around each 



50 COMMUNITY HYGIENE 

corner. The sills of the house are laid in cement 
with more strips of this wire mesh imbedded in the 
cement and spiked to the beams. The doors leading 
into the cellar and at the back of the house are 
made with carefully leveled cement or iron and 
steel sills, and protected with a strip of iron around 
the bottom, so that there is not the smallest chink 
through which either mouse or rat can squeeze or 
gnaw his way into the house. 1 It must, of course, 
be carefully drained by a tile laid all around the 
upper, or hill, side of it, at, or slightly below the 
level of its floor, so that no rain or ground water 
can get into it. 

Such a cellar is ratproof, waterproof, dry, well 
lighted and ventilated. Every particle of its inner 
surface can be swept clean with the broom and 
scrubbed or washed down with the hose. It is not 
merely the best for keeping disease out, but also 
the best for keeping health in. People who live in 
a house with such a cellar will never have chilblains, 
which come from cold, damp, unventilated floors, 
and they will be much less likely to catch colds and 
other infections. 

1 The same methods protect a house entirely against cockroaches 
and beetles. If the windows and doors are made tight-fitting and 
protected with screens, there will be no flies, and very few germs of 
any sort. 



CHAPTER VII 

WASHING AND LAUNDERING 

Eternal cleanliness the price of life. Nothing will 
keep tidy of itself. Everything that lives and grows 
and moves has a perpetual tendency to scatter 
waste, pile up dirt, and accumulate stains and 
smears. The moment you stop cleaning yourself or 
your house, the dirt begins to gather again. We 
must wage a constant struggle to keep clean. 

This lifelong war of the scrubbing-brush sounds 
almost discouraging. Fortunately, after we have 
once formed the habit, it becomes second nature, 
and we come to enjoy it. We feel so much better, 
our houses are so much more pleasant and whole- 
some, that we take a real satisfaction in keeping 
clean. 

Scrubbing the floors. Scrubbing the floor is per- 
haps one of the least attractive forms of cleaning. 
Yet many housewives positively enjoy scrubbing 
their kitchen floors, and take pride in a clean, white, 
shining surface underfoot. One of the most impor- 
tant things in planning for a new house is the floor- 
ing. All downstairs floors, and as many of the up- 
stairs floors as possible, should be made waterproof 
and watertight. It should be perfectly easy to scrub 
them and to wipe them with a damp cloth or a mop 



52 COMMUNITY HYGIENE 

instead of sweeping them with a broom or brush. 
With floors of this character, it is much easier to 
keep the house looking clean and attractive. 

Moreover, the floor is the chief settling-place for 
dust and germs which may be in the air. On the 
floor they are perfectly harmless, as far as our 
health is concerned, if we only have the sense to let 
them lie. This does not mean that we should never 
disturb the dust on our floors. It does mean that 
we should remove the dust in such a way as to avoid 
throwing it up into the air again. Nothing more 
ingenious could be devised than our present methods 
of dry-sweeping and dusting to start up the dust 
and germs from the floor and whisk them into our 
noses and mouths and eyes. 

If our floors are laid of hardwood, or of narrow- 
boarded, closely fitted and matched soft wood, and 
then well painted or oiled and polished, so that they 
can be wiped with a damp cloth or slightly oiled 
rag, the sweeping process is largely solved. If the 
floor boards, moldings, window casings and seats, 
tables and larger furniture are cleaned in the same 
way, we shall be able to keep our rooms really dust- 
less and to avoid a large part of the risks of the 
spread of disease through dust. Various composi- 
tions of asbestos, wood pulp, rubber, etc., which set 
hard and give a smooth, washable surface, are also 
very good. They cost a little more to lay than wood, 
though not more than good hard wood, but are 
more sanitary and more easily cleaned. 



WASHING AND LAUNDERING 53 

Washing the windows and paint. Windows ought 
to be kept scrupulously clean and bright, both to 
let in all the light possible and to allow us to see out 
through them clearly. Glass, while easy to wash, is 
hard to polish. On account of its transparency, 
every slight smear or film of dirt shows. A trace of 
soap, a mark of the scrubbing-cloth, or even the lint 
from the drying-cloth, gives the window an untidy 
appearance. In fact there is difficulty in using soap 
upon glass unless it can be rinsed off thoroughly 
with very hot water. Water used in washing win- 
dows must be frequently changed, because the dirt 
which was washed off in the first application leaves 
a thin smear when the pane dries. It is necessary, 
also, to use a great deal of water, spraying the panes 
down with the hose on the outside if possible, wiping 
them with a soft, clean cloth, and finally polishing 
them with a piece of chamois leather which leaves 
neither lint nor pattern marks on the glass. 

Paint, also, must be cleaned carefully. The 
smooth shining surface or finish of paint is formed 
of a dried and hardened film of linseed oil. This 
resists cold water and most ordinary liquids, but, 
like any other fat, can be dissolved by very hot 
water or by soap and strong alkalies like ammonia 
or soda. Therefore paint should be washed with 
cloths dipped in cold or lukewarm water. If there 
are spots which will not come off, these may be 
removed by slightly moistening the cloth with 
alcohol or kerosene ; but almost any of the ordinary 



54 COMMUNITY HYGIENE 

soaps, washing-powders, and ammonia will dissolve 
the film and eventually wash off the paint. 

Soaps and sodas. Everybody knows the steamy, 
soapy smell of wash-day. Most of our washing is 
now done indoors with boilers and tubs. In an 
earlier day — and still in many parts of Europe — 
the washing was done out of doors. Women and 
girls came down to the edge of the stream with a 
bundle of clothes on their heads, knelt down beside 
the water, and washed the garments in the running 
water, scrubbing them on a flat stone, or beating 
them with clubs to pound the dirt out. Then they 
wrung out the washed clothes, shook them, spread 
them on the grass to dry, and sat down to rest. 

It seems absurd to ask why we use water for 
cleansing purposes. Most of us, if asked, would say, 
" Why, it is natural! " or " Everybody does it! " 
A chemist would tell us that water is the most 
universal solvent. That is to say, it will melt and 
dissolve more different kinds of substances than all 
other liquids put together. It is common to think 
that alcohol or benzine are better solvents than 
water, but this is only because they will dissolve one 
class of substances which water will not dissolve ■ — 
the fats, oils, and greases. These, however, represent 
only one kind of dirt, and there are many substances 
which alcohol or benzine will not dissolve at all, but 
which will melt readily in water. 

Most of the dirt upon our clothing will come out 
in water. Some kinds, however, will not — chiefly 



WASHING AND LAUNDERING 55 

those which have some oil or grease in them. In 
order to make water dissolve these, we first heat it, 
and then add to it some other substance which will 
dissolve or combine with fats. Usually this is some 
form of alkali, such as soda, potash, or ammonia. 
As all these alkalies, when pure, are strong and 
likely to burn the hands, we dilute them with some 
form of fat. They can then be handled conveniently 
and set free slowly, in small amounts, so that they 
will not attack our skin. This combination of an 
alkali and a fat makes what we call soap, soda with 
the firmer fats forming hard soap, and lye or potash 
with pork, oil, or soft fats making a soft soap. 

We must be careful, however, not to use these 
alkalies too strong. They have bad effects upon the 
hands, and also they attack the fiber of clothing, 
causing it to break down and wear out sooner than 
it should. 

Ammonia, though an excellent solvent and 
cleanser, cannot be used as extensively as the other 
two alkalies, because it is what the chemists call 
volatile — that is, it evaporates in the air, forming 
a gas. This gas, as every one knows who has hap- 
pened to take a whiff at the ammonia bottle, is 
pungent and irritating. In considerable amounts it 
is poisonous. An attempt to use ammonia on a large 
scale for washing, especially with hot water, would 
be both disagreeable and dangerous. 

Our usual methods of laundering or washing are 
based on sound chemical methods, although we have 



56 COMMUNITY HYGIENE 

developed them without so much as knowing the 
name of an alkali or a solvent. Usually the 'clothing 
and household linen to be washed are sorted, so as 
to separate the colored fabrics from the white, and 
the coarser and more soiled from the finer and 
cleaner. Then the different groups are plunged into 
tubs or boilers of water, to which has been added 
soap or washing-powder — usually some form of 
the two fixed alkalies, soda or potash, or occasionally 
a little kerosene for its solvent effect on fats. Some 
allow the clothing to soak in this alkaline solution 
overnight. Others put the clothes to soak in a 
boiler on the stove, and bring the water to the boil- 
ing point. Boiling water, with the assistance of the 
alkali, dissolves the dirt in the clothing, while the 
bubbling of the gases in boiling mechanically assists 
in the process. Then the clothing is rinsed in two 
clean waters to remove the dissolved dirt and soap, 
passed through a wringer, and hung out on a line. 
Drying clothes out of doors serves- a double purpose, 
for it not only dries them rapidly, but it gives an 
opportunity for the germ-killing action of the sun 
and air upon any germs or poisonous dirt which may 
still happen to cling to them. 

The three other processes, bluing, starching, and 
ironing, have little to do with health, but are in- 
tended merely to improve the appearance of the 
fabrics. Ironing is of some benefit from a hygienic 
point of view, because the heat insures a thorough 
drying of any traces of moisture, and helps to de- 



WASHING AND LAUNDERING 57 

stroy, or at least discourage, any germs or toxins 
which may still cling to the garments. Starching 
merely fills the fabric with a harmless powder which, 
when moistened and heated, stiffens it and gives it 
the power of taking a glossy finish under the flat- 
iron. 

Bleaching and bluing. Bleaching is a means of 
whitening linen or cotton or woolen fabrics by ex- 
posing them to the light. This whitening is due 
partly to the oxidation of the substances which give 
the fibers their original yellowish or grayish color, 
and partly to changes caused by the light. It also 
helps to remove certain oily or gummy substances 
which were of use to the fiber in its growth as a plant, 
or upon the back of the sheep. The process has little 
hygienic value, except that the prolonged exposure 
to air, light, and sunshine helps to make the cloth 
cleaner and more wholesome. It also makes it 
lighter and more porous by removing the heavy, 
gummy, unpleasant coloring matters. Nowadays a 
great part of the bleaching is accomplished by ex- 
posure of the cloth to the fumes of various chemicals. 
Most of these are fairly good germicides and none 
of them are particularly harmful. Bluing accom- 
plishes the same purpose as bleaching by hiding the 
yellowish tint of the cloth. 



CHAPTER VIII 

THE BATHROOM 

The shower and the tub. The presence or absence 
of a bathroom is what chiefly marks a house as 
modern or old-fashioned. A good bathroom re- 
quires the presence of water pipes and a con- 
stant flow of water under pressure in the house. 
Outside of the town or city limits, the problem of 
securing the necessary water pressure is a matter of 
considerable difficulty and expense. However, it is 
now entirely possible to install a water-supply sys- 
tem in a single house at a moderate expense, provid- 
ing there is a good well or spring which furnishes a 
sufficient flow of water. Sometimes a reservoir may 
be made by damming a creek or brook. Then all 
that is needed is a tank at a sufficient height to force 
the water as high as the second story, and some 
means of pumping the water into the tank. There 
are also air-pressure methods which dispense with 
a tank and do away with the danger of freezing in 
winter. 

The cheapest method of pumping — cheapest 
both to install and to run — ■ is a windmill. As this 
depends on the wind for motor power, it is some- 
what uncertain, is liable to get out of order, or may 
be damaged by storms. A better source of power is a 
gasoline engine, which can be installed at slightly 




EVERYTHING RIGHT IN A BATHROOM 



60 COMMUNITY HYGIENE 

more expense than a windmill, and which may be 
relied upon — barring ordinary accidents — every 
day in the year. It is easy to run, and although its 
fuel is not as cheap as wind, the total expense of 
pumping enough water to supply an ordinary 
household is only a few cents a day. 

The bathroom should have good air and light and 
waterproof walls and floor. A cement or tile floor is 
best, and a dado or wainscoting of tiles around the 
part of the room where the bath stands is a great 
advantage. 

The question, " Which is the better form of bath, 
the shower or the tub? " can only be answered by 
saying, " Both." If water is scarce, the shower has 
the great advantage of taking only about a fourth 
of the amount required for the tub. It gives just as 
good results in the way of cleanliness, and almost 
as good results in the way of exhilaration and com- 
fort. In fact, it gives a cleaner finish than does the 
tub, because every particle washed off the surface 
of the body goes straight down the escape pipe. The 
tub bath, if carelessly taken; may result in loosening 
the dirt from the most soiled portions of the body — 
hands, feet, and face — and dissolving it in the 
water, only to leave a thin film of it all over the 
body surface. It is a good way to combine the two, 
soaking and rubbing thoroughly in the tub, and 
then standing under the shower for a few seconds 
to finish off. Before getting into the tub or under 
the shower it is advisable to wash the hands, face, 



THE BATHROOM 61 

and feet in the hand bowl, or a small foot tub. This 
keeps the bath water clean and makes the bath more 
pleasant and wholesome. Also, from a practical 
point of view, it makes the bathtub easier to scrub 
out and keep clean. 

Hot baths and cold. There is a difference of opin- 
ion as to whether hot water or cold is better for 
bathing. Each is excellent in its place. Hot water 
has the great advantage of cleansing better, on ac- 
count of its greater solvent power. It has the corre- 
sponding drawback of dissolving not only the greasy 
or oily dirt on the surface of the body, but also the 
natural protective oil of the skin. Too prolonged 
and too frequent washing with it is likely to leave 
the skin dry, irritable, and inclined to crack, because 
it has been deprived of its natural oil. Except when 
there is considerable dirt on the hands and face, it 
is usually best to wash in cool water, and avoid 
robbing the skin of its natural protection. Washing 
with hot water at night is comparatively harmless, 
because the skin is protected by the bedclothing 
for the next eight or nine hours, and not exposed to 
either changes of air or irritation of any sort until 
it has had time to recharge itself with its oily pro- 
tective covering. In the case of dirts which stain 
the hands deeply, it is best not to scrub too hard or 
use too hot water or too strong soap, for you thus 
inflict much more damage upon the skin than the 
stain itself can do. Get off what you can with a 
moderate washing. Then let the perspiration grad- 



62 COMMUNITY HYGIENE 

ually loosen the stain and work it up toward the 
surface where it can be washed off, even if the proc- 
ess takes two or three days. 

Hot baths should be taken at night, because they 
draw the blood to the surface, thus helping the skin 
to clean itself by perspiration. In the same way 
they help to wash the fatigue toxins out of the tired 
muscles and take out the soreness. A hot bath once 
br twice a week is sufficient. For daily morning use 
cold, or cool, baths are preferable: first, on account 
of their exhilarating effect; second, because they 
tone up the skin and protect against cold when you 
go out of doors; and third, because they do not 
deprive the skin of its natural oil and protection. 
There is no need to make a punishment of cold 
baths. Have them just cool enough to give you a 
pleasant sense of coolness and a gentle shock or thrill, 
and yet not so cold as to make it difficult to warm 
up and react promptly after them. If you are strong 
and well, a good plunge into cold water is a splendid 
tonic; but if you don't warm up and look rosy and 
feel comfortable directly after it, then you must 
add more warm water next time. 

Brushes. Brushes have the same advantages and 
drawbacks as hot water and soaps. They take off 
the dirt, but they also remove a good deal of the oil 
of the skin with it, and — if used too enthusiastically 
— even some of the surface layers of the skin itself. 
They are chiefly of value for scrubbing places which 
it is hard to reach with water, such as under the 



THE BATHROOM 63 

finger nails and toenails. The nail-brush should 
be used thoroughly at least once a day, preferably 
at night. We are apt to put our fingers near our 
mouths or noses at night, or to sleep with our hands 
covering or shading our faces. If any dirt or germs 
are left on the fingers, they can easily get into the 
mouth, nose, or eyes. Larger and softer brushes, 
known as flesh-brushes, are also useful to curry the 
skin and stimulate the circulation through it; but 
they should be used cautiously until the skin has 
become hardened to them. Otherwise they may 
scratch off the delicate surface layers, causing irri- 
tation and leaving cracks where dirt can lodge. 

Powders and cold creams. Good powders and 
creams have a certain amount of usefulness upon 
the skin, but much less than is usually supposed. 
They help to repair the ravages of too energetic 
scrubbing or too hot water or too strong soap. The 
powders make a protective coating for the skin and 
fill up any tiny cracks. The creams do the same 
thing and, in addition, replace the natural oil of the 
skin if this has been scrubbed out. They are also 
useful, if the skin has become chapped or chafed or 
sunburnt or irritated in any way, in forming a 
soothing and protecting coating over the irritated 
surfaces. Beyond this they have little utility, and 
the habit of industriously rubbing them upon your 
face or hands every night is largely a waste of time 
and material, except for the benefit to the skin by 
the stimulating effect of the rubbing. 



64 COMMUNITY HYGIENE 

The only thing of the slightest value in these 
face creams is the oil or fat in them. There is no 
drug or remedy or preparation as yet discovered 
which will be of the slightest benefit to the healthy 
skin, no matter now faithfully applied. If the skin 
is in need of an extra supply of oil or protective, 
cold creams or powders may have some use; but if 
not, the cold cream manufactured by the skin itself 
is far better than anything invented by the pharma- 
cists. The same may be said of the various cloths, 
sponges, or pads which are used in rubbing the face. 
Not one of them is equal to our natural massage 
pads, the firm, elastic, rubber-like tips of our fingers. 
A moderate amount of rubbing with these night and 
morning is a good thing for the complexion. The 
skin of the face perspires less than the body, is not 
rubbed at all by garments, and is the better for a 
little gentle rubbing and exercising. It is easy, how- 
ever, to overdo even this form of massage. Increas- 
ing the flow of blood into the skin too greatly tends 
to thicken and harden it, and to cause the tiny 
hairs with which the whole surface of our faces is 
covered to grow slightly and become thicker and 
darker. 

The various cold creams are composed chiefly of 
some form of oil or fat combined with some harmless 
powder to give them body or color, and scented to 
suit the taste. Formerly they were made largely of 
lard, with a little oil of almonds and some sperma- 
ceti. To-day vaseline, cosmoline, or some of the 



THE BATHROOM 65 

other heavier petroleums are largely used. The so- 
called " vanishing creams " which can be rubbed in 
and caused to disappear are largely made of the curd 
of milk. The so-called " liquid creams " contain 
extract of quince seeds and other kinds of gums, 
with coloring and scenting substances added. 

The complexion that won't come off. All that the 
most elaborate and expensive of complexion im- 
provers can do is to patch up a protective surface 
over the skin when it has become cracked or dried 
or irritated. Perfectly healthy, clean, vigorous skin 
has a finer surface, a better bloom, and a richer 
color than anything that can be smeared on it. If 
the complexion is pale, it is because the blood is not 
rich enough, or is not being pumped through the 
skin with sufficient rapidity and in large enough 
amounts. The only way to cure this defect is by 
food and exercise in the open air. The beautiful 
glow of color in a good complexion comes from be- 
low the skin and cannot be imitated by anything 
painted on the surface. Keep your face well 
washed, moderately rubbed and massaged, your 
body well fed, and your muscles well exercised, and 
you will usually have a good complexion. Avoid all 
coloring substances for the face, which are not only 
objectionable to people of refinement, but some- 
times are positively injurious. 

The hair and the scalp. What has been said of 
the care of the skin applies to the scalp also. It 
should be well washed, well brushed, and given 



66 COMMUNITY HYGIENE 

plenty of air and sunlight. Beyond that, there is no 
known thing which can be done to improve it or 
make it grow a thicker or better crop of hair. 

The hair is a part of the skin and grows out of a 
down-folded pouch of the skin. It is self-oiling, and 
none of the salves and tonics - and restorers and 
dressings have the slightest effect in improving its 
condition or increasing its growth. It should be well 
brushed, because brushing is the only means which 
will clean it and give it friction. While most of the 
cleansing needed by the hair and scalp can be 
secured by thorough brushing, a good washing in 
hot water and soap about once a week for boys and 
once in two weeks for girls is helpful, since it re- 
moves any traces of dirt or dust which have escaped 
the brush. 

The use of towels. The chief use of towels is 
to dry the skin or hair after washing. They are 
also useful on account of the rubbing and friction 
which they give the skin. They should be of loose 
spongy material in order to absorb readily the mois- 
ture from the skin. The same texture gives them a 
slightly rough surface which increases their stimu- 
lating effect. They should, of course, be washed 
frequently — at least twice a week. It is better still 
to have clean towels every day; and no one should 
use a towel which has been used by any one else. 
They should be hung where the air "and, if possible, 
the sun can get at them. Even after the most care- 
ful washing and sluicing, a little of the oil of the 



THE BATHROOM 67 

skin and perspiration will be rubbed off on them; 
and these, if allowed to remain warm and damp, 
will quickly decompose and become slightly rancid. 
It is well to remember that towels are simply to dry 
with, not to wash with. Some boys are inclined to 
do about half their washing on the towel. 

The internal bath. It is hardly necessary to re- 
mind ourselves that we have an internal surface, as 
well as an external one, which is also in need of being 
kept clean and sanitary. The water that we drink 
and the secretions of our alimentary canal auto- 
matically clean and flush it, provided we are regular 
and systematic in allowing an opportunity for the 
escape of the waste. It is a considerable advantage 
to have a toilet-room in the house instead of twenty 
or thirty yards away out of doors, as used to be 
customary before water-supply systems were intro- 
duced. Frequently the call of nature will be dis- 
regarded or a response to it postponed in stormy 
or cold weather on account of the discomfort of a 
trip to an outdoor toilet. It is impossible to make 
cleanliness, either internal or external, too easy, and 
the bathroom and the toilet-room should be made 
as accessible, as attractive, and as comfortable as 
possible. 



CHAPTER IX 

THE FURNACE AND STOVES 

Making our own climate. One of the most won- 
derful and useful discoveries ever made by the wit 
of man is fire-making. Before he could " make 
magic " in the shape of flame, man was an insignifi- 
cant little prowling jungle beast, who climbed into 
the tree-tops every night to be safe from the attack 
of wild animals. 

With fire in his hands, he had a charm against the 
fiercest beasts of the jungle. The circle Of flickering 
light around his camp-fire was a haven of safety all 
night long. Fire brought him down from the trees 
and set him to swaggering on his hind legs and 
looking the world in the face. Then came cookery 
and pottery. One marvelous day he built his camp- 
fire on an outcropping ledge of blackish rock. The 
stuff melted, ran, hardened again, when it cooled, to 
a dark shiny metal — and his second greatest gift, 
iron, was in his grasp. Iron put an edge on his 
weapons, a tip on his plow, and gave him real tools 
with which to build boats, houses, and wheels and to 
conquer the earth. No wonder that most primitive 
races have legends relating how fire was brought 
down from heaven. They even give the name of the 
rash and venturesome mortal who first stole fire from 
the sky. 



THE FURNACE AND STOVES 69 

Even to this day we are still so immensely proud 
of our discovery that we are inclined to make too 
much of it in more ways than one. We make our- 
selves not only warm, but too warm; and our in- 
stinct for comfortable warmth is the only instinct 
against which we have to fight in the interests of 
our health. This is merely because it is the newest 
instinct and is not yet properly adjusted. We 
seldom drink too much water, or eat too much food, 
or take too much sleep, or breathe too much air, 
but we are inclined to make our rooms far too warm 
and our clothing too heavy. We can hardly blame 
ourselves greatly. It feels so good to be warm, and 
it is a marvelous triumph to keep ourselves not 
merely alive, but warm and comfortable in the 
sternest winters. The fire magic has liberated us 
from the tropics and made us citizens of the world, 
free to live anywhere on the globe where the sum- 
mers are long enough to grow food to carry us 
through the winter. 

One reason why we are inclined to make our 
houses too warm is that for the first time in history 
we have heating apparatus which will really heat, 
as well as houses built tightly enough to keep out 
the cold air. The old-fashioned open fireplace, 
which we often recall with poetic regret, was little 
better than a farce for heating purposes. Most of 
the heat made on its hearth went up the chimney. 
No matter how one piled on the logs and built up 
the fire, the only part of the room which was really 



70 COMMUNITY HYGIENE 

warm was a half-circle from six to nine feet deep 
directly in front of the fire. The draft made by the 
roaring fire kept the rest of the room cold. Besides, 
most old-fashioned houses were so poorly built that 
the wind fairly whistled through them whenever 
the thermometer dropped to zero or lower. 

How to keep warm air fresh. However, there is 
nothing unwholesome about warmth. In fact, a 
reasonable and comfortable amount of it is necessary 
to health. Our modern air-tight houses with power- 
ful furnaces are much more healthful than were the 
old, clammy, drafty stone heaps and. barns which 
used to be called houses. There is no harm in having 
the air too warm, or even a little too dry, providing 
it is kept fresh and pure. It takes only a little 
thought and brains to enable us to have our air 
both warm and fresh. There is plenty of perfectly 
pure fresh air just outside our houses. All we need 
to do is to open the windows and let it in. 

In fact, when we heat air, we set it moving at once, 
because the heat causes it to expand, like almost 
every other substance. This expansion makes it 
lighter, and it begins to rise. All we have to do is 
to provide an opening through which it can escape. 
This opening should be near the top of the room, 
because the hot air rises to the ceiling. By the same 
law of expansion, the colder outside air just as 
readily rushes into the room and fills the space 
vacated by the hot foul air. When we open a 
window at the top on a cold day a double current 



THE FURNACE AND STOVES 71 

begins to flow at once — hot air pouring out 
through the upper half or two thirds of the opening, 
and cold air pouring in through the lower third or 
half. By carefully adjusting the window sash so 
that neither too much cold air flows in nor too little 
hot air flows out, we can keep a room both comfort- 
able and perfectly wholesome. 

Steam heat and furnaces. We often hear steam 
heat and furnaces denounced as unwholesome, be- 
cause they are liable to overheat and overdry the 
air in our houses. This is only because they are not 
intelligently managed. Even at their worst, they 
are better for the health than the old-fashioned 
open fireplace or scattered stoves. Each form has 
special advantages and disadvantages. The furnace 
is much cheaper to install and requires less skill to 
operate. Nowadays, any house of five or more 
rooms with a cellar can have a furnace. In fact, it 
will really save money in the long run, as the fuel 
bills will not be much greater than for a stove in 
each room. Add to this the saving in labor and 
expense of cleaning and general wear and tear from 
carrying coal to and ashes from the separate stoves 
in each room, and you find little financial difference 
in the two methods. The furnace has also the ad- 
vantage of drawing its air more or less directly from 
the outside. It comes through the cold-air shaft 
into the hot-air chamber, where it is warmed, and 
then rises through the pipes and registers to the 
different rooms of the house. This method assures 



72 COMMUNITY HYGIENE 

us a greater supply of hot air that is fairly fresh and 
pure. However, a certain amount of the cold air 
from the floor of the living-rooms flows into the hot- 
air chamber, either through cold hot-air pipes, or 
through special pipes provided in some systems of 
house furnaces for the purpose. Consequently the air 
coming up through the registers is not always per- 
fectly pure. On the other hand, the furnace method 
has the disadvantage of being rather wasteful of fuel 
as compared with steam or hot water. Also, it will 
fail to heat properly certain rooms in the house, or 
it will not heat certain rooms when the wind is from 
a particular quarter. It is also likely that, when the 
temperature drops to zero or below, the engineer of 
the furnace, in order to save the quantity of fuel 
needed to heat this extremely cold air up to house 
temperature, will shut off the cold-air duct opening 
to the outside and draw his air from the cellar or 
through cold tubes from the unused rooms of the 
house. On the whole, however, a little care and 
hygienic intelligence in handling the house furnace 
will give good results both in point of comfort and 
of health. 

A great hygienic advantage of any of these central 
systems of heating located in the cellar or basement 
is that they keep the air of the cellar dry, warm, 
and wholesome, and warm the entire house. It is 
well to have the floors and passageways fairly warm, 
so that the occupants of the house may move about 
freely, and to have the bedrooms sufficiently warm 



THE FURNACE AND STOVES 73 

to enable one to open a window at night without 
fear of being almost frozen while dressing in the 
morning. As a matter of fact, it is only in houses 
which are thoroughly well warmed, usually with 
some central method of heating, that you will secure 
proper ventilation in winter time. 

Steam or hot-water systems of heating are more 
expensive to put in and skill is required to operate 
them. However, they have the advantage, where 
the number of rooms to be heated is considerable, 
of using less fuel because they waste less heat; of 
preserving a more uniform temperature; and of 
being much more reliable than the hot-air furnace 
as a means of heating every room in the house. The 
problem of ventilation in large buildings may be 
solved by providing some special artificial system 
of ventilation. In private houses, and in most school 
buildings, ventilation can be managed very satis- 
factorily by a skillful use of open windows. 

Gas and oil. Gas should be burned in a fireplace, or 
under a metal hood with a pipe opening into a flue. 
The same may be said of the oil stove or heater. 
Neither gas nor oil stoves should be relied upon for 
steady heating, but both are occasionally useful. 
If the stove is carefully watched, and the room is 
provided with plenty of fresh air, such heaters add 
much to the comfort of a room without being dan- 
gerous to health. But they should always be 
regarded with suspicion. 



CHAPTER X 

THE BEDROOM 

Why we need air at night. There is no room in 
the house which should be more thoroughly flushed 
with fresh, cool air than the bedroom. We need air 
at night, just as we do in the daytime. Though we 
breathe more slowly when we are asleep than when 
we are awake, because we are not burning up our 
body fuel so rapidly by exercise, we really need as 
much oxygen per hour when we are asleep as when 
we are awake; for, while we breathe in more air 
during the daytime, we do not breathe it in fast 
enough to keep pace with the amount of work done 
with our muscles. Consequently, carbon dioxide 
and other waste products collect in our blood during 
the day faster than we can dispose of them. 

One of the reasons why we sleep and rest at night 
is to regain our balance of oxygen, throw off our 
carbon dioxide and other poisonous wastes, and lay 
in a store of surplus oxygen for the next day. It is 
most important, therefore, that we should have an 
abundance of fresh, pure air to breathe at night. 

How our skins breathe. Moreover, we need 
plenty of air in our bedrooms because our skins give 
off a great deal of moisture and waste products and 
some gases. During the day this vapor and gas is 



THE BEDROOM 75 

more or less held in by our thick, heavy, close- 
fitting, and often sweaty clothing. When we undress 
at night, we give our skins a good breath of fresh 
air. When we put on light, loose night clothing and 
get between clean sheets, the skin keeps on breath- 
ing and purifying itself all night long better than it 
can do in the day. If the bedroom is not properly 
ventilated and the bed is not well shaken up and 
aired during the day, these gases and watery vapors 
from the skin collect in it. That is what gives a 
stuffy, sour smell to a bed which is not properly 
cared for, or a bedroom where the windows are kept 
shut. 

Why drafts are healthful. When we are warm in 
bed, under good blankets, we can endure and enjoy 
a current of cool, pure air blowing across our faces, 
even when the temperature of the room is below forty 
degrees. It is a good thing, not merely to have 
plenty of fresh air at night, but to have a current 
of it that we can distinctly feel blowing across our 
faces. Lying still all night long, with our heads half- 
buried in the pillow, the warm, impure air which we 
breathe out is more likely to hang about our heads 
and faces than when we are moving about in the 
day. The only thing which carries our breath away 
from our faces, and from the hollow in the pillow, 
and from under the bedclothes, is the fact that air 
is warm and tends to rise. This change, however, 
occurs slowly, and often is not sufficient to keep 
the air about our faces and nostrils pure. Indeed, 



76 COMMUNITY HYGIENE 

in hot weather, when the temperature rises above 
eighty degrees, there is danger of our faces becoming 
"drowned" in a pool of our own breath, unless 
there is a current of air to blow it away. 

Moreover, we have found that one of the tonics 
required to keep us in health is the striking of cur- 
rents of cool or cold air upon various parts of our 
body surface. In fact, drafts, unless cold enough 
to make us really uncomfortable, are not danger- 
ous. Their alternate chilling and warming, breezing 
and blanketing of the surface can go on more or less 
all over our body while we are up and about in the 
day. At night, the only part of our surface open to 
this kind of healthful stimulation is the face, and we 
need for health a cool, fresh current of air blowing 
across our faces all night long. 

Sheets, blankets, and coverlets. The covers which 
we put on our beds at night are like a loose-fitting 
suit of clothes. They are made up of much the same 
materials as our day garments, and for the same 
reasons. 

Next to our skins we put a sheet of cotton or linen, 
partly because it is cool and smooth and soft and 
feels comfortable, but chiefly because it can be 
easily washed and frequently changed. As the 
sheets catch a good deal of the perspiration and 
waste products which are given off by our skins 
during the night, they should be thoroughly aired 
and exposed to the light and sun every day. When 
we rise, we should turn down the covers and leave 






THE BEDROOM 



77 




A BEDROOM AND PLAYROOM 

Of course, it is pleasant to have a special playroom for tea-parties. Still, you can 
have healthy, happy play in your own room if you have plenty of sunshine, air, and 
shelves for books and toys. 



the bed open for at least an hour or two before it is 
made up again. Because the sheets can be so easily 
washed and changed, it is a good thing to make 
them two or three feet longer than the blankets, so 
that they can be turned back over the blankets and 
coverlets at the top in a broad fold which will sta] 
in place during the night and keep the heavier cov- 
erings from coming in contact with our faces. 

Next to the sheets come warm, porous woolen 
stuffs known as blankets. Almost every nation or 



78 COMMUNITY HYGIENE 

tribe which can grow or get wool sleeps under 
blankets. This is because they combine lightness 
and wearing quality with warmth. In an earlier day, 
they were easier to fold up and carry about to the 
next night's sleeping-place than any other mat or 
skin. Bacon and blankets are the two chief neces- 
sities of the soldier the world over. 

While woolen blankets are warmest, a satisfactory 
substitute for all but the coldest weather is now 
made of loosely woven and fleecy cotton. These 
cotton blankets are not so warm in proportion to 
their weight, but they are cheaper and more easily 
washed. Unless handled very carefully, they are 
inclined to shrink, become harder, and-lose a great 
deal of their porousness. The warmth of bedding, 
as of garments, depends largely upon its porous- 
ness, that is, the amount of air which it can keep 
entangled in its meshes. 

Over the blankets comes the quilt or coverlet. 
This may be a purely ornamental affair intended to 
make the bed look white and neat and to cover the 
blankets from dust. This type of cover is good, 
because it keeps the blankets clean and, when 
pulled up over them at the top at night, prevents 
them from coming in contact with our faces. 
Spreads should not be made so ornamental that 
there is any hesitation about having them washed 
frequently. 

The other type of coverlet or comfort is that used 
in cold weather for additional warmth. This should 



THE BEDROOM 79 

be as light and porous as possible to give the maxi- 
mum of warmth with the minimum of weight, and 
also to interfere as little as possible with the breath- 
ing of our skins and the circulation of air through 
our bed coverings. One of the best combinations 
from both these points of view is the cotton-lined 
coverlet, made of layers of fine cotton-batting cov- 
ered with cheesecloth. Such coverlets may be made 
as ornamental and dainty as one pleases, with silk 
borders, and knots of ribbon or silk or yarn; but they 
should not be made too delicate to wash. If washed 
at regular intervals, and aired and ventilated thor- 
oughly every day, they can be kept perfectly clean 
and sanitary. When the night is cold enough to re- 
quire more than three blankets it is best to use a 
comfort, as four blankets (two pair) are uncomfort- 
ably and undesirably heavy. Other winter coverlets 
are filled either with eider-down or with ordinary 
feathers. In Germany, the bedding is still of a de- 
lightful simplicity. You lie down upon one feather 
bed and pull another over you — ■ with sheets, of 
course, in between. It takes a lifelong training to 
be able to stay under that uneasy feather bed with- 
out sticking out, first at the end, then at the sides, 
and finally to avoid shuffling it off on the floor. 
These down coverlets have the great objection of be- 
ing almost air-tight. If they are a little too heavy, 
or the night is unexpectedly warm, they are likely 
to overheat and to prevent the proper ventilation 
of the skin. The German ones may not, because 



80 COMMUNITY HYGIENE 

they leave wide gaps all round the edge of the 
bed. Down coverlets should be used cautiously, 
particularly in the case of young children who are 
likely to throw off the covers and get chilled. If 
eider-down quilts are made quite light, and not too 
wide, so as to lie as a kind of flat covering over the 
body without tucking tightly in at the sides, they 
are fairly healthful and very comfortable. 

Pillows and mattresses. Pillows prop up the 
head and keep it in a straight line with the back- 
bone when we are lying down. Man is the only 
animal needing a pillow, because he is the only one 
having square or projecting shoulders. The thick- 
ness of the pillow should be exactly that of the 
breadth of the shoulder, from the side of the neck to 
the outer end of the collar-bone. Anything lower 
strains the neck by letting the head sag, and makes 
us uncomfortable by interfering with the circulation 
of the blood through the brain. Anything thicker or 
higher strains the neck in the opposite direction, and 
by pressure upon the carotid arteries and jugular 
veins also interferes to some degree with the circula- 
tion of the blood through the brain. For some fool- 
ish reason the impression has gone abroad that it is 
healthful to sleep without any pillow at all. There 
is absolutely no foundation in hygiene or in com- 
mon sense for this idea. 

Pillows should be made of some light, soft, fairly 
firm substance, covered with a washable case; and 
the experiments of centuries have shown that noth- 



THE BEDROOM 81 

ing combines these various good points so well as 
some form of down or fine feathers. Our primitive 
ancestors were not so particular. A convenient 
stone, a log of wood, a saddle, a bag of meal, or a 
folded cloak served the purpose. The Chinese to-day 
use nothing for a pillow but a rounded and polished 
log of wood about four or five inches in diameter. 
If the pillow is too soft, the head will be buried in 
it so deeply that the nostrils will be partially ob- 
structed, and the foul air of our breath will settle 
down into the hollow thus made. 

A mattress is a thick, padded covering for the 
bed-springs, firm enough to support the body, but 
soft enough so that the projecting bones of our hips 
and shoulders will not become sore from pressure. 
The best materials for this purpose are curled horse- 
hair, felt, straw, or wool. The best of these is curled 
horsehair, because it is fairly firm, is elastic and 
porous, and can be thoroughly cleansed. The worst 
is wool, because it is inclined to pack, lose its por- 
ousness, and absorb odors and perspiration. Feath- 
ers once were commonly used for this purpose, but 
except in very cold weather and in poorly heated 
rooms they should be avoided. While they are soft 
and warm, they rise up on all sides of the body so 
as almost to imbed it, and interfere seriously with 
the proper action of the skin. 

There is no merit, however, in having a mattress 
too hard. It should be firm enough to support the 
body evenly on the projecting bony prominences of 



82 COMMUNITY HYGIENE 

the shoulders and hips, the knees and ankles, and 
yet soft enough to be perfectly comfortable and give 
no feeling of soreness or strain. 

Windows and walls. Since a bedroom needs to 
be well ventilated, it should have plenty of windows, 
preferably on two sides of the room. If this is im- 
possible, the bedroom should have at least two win- 
dows, even if both of these are on the same side, to 
allow some circulation of air between them. 

The bedroom needs an abundance of light and 
particularly of sunlight. Windows should be cur- 
tained as lightly as possible, and provided with 
only sufficient blinds or shades to secure the proper 
protection while dressing and undressing, and 
should be open wide to light and sunlight all day 
long. Few things are more unwholesome and de- 
pressing than a dark, airless, poorly lighted bed- 
room. 

The walls should be painted or papered in some 
light, cheerful shade, both for the purpose of in- 
creasing the purifying effect of light and also to give 
the room a cheerful, attractive appearance. They 
should be easily wiped down and kept clean, and 
should be hung with but few pictures and ornaments. 
These catch and hold dust, and interfere with the 
sweeping down of walls with a broom covered with 
a cloth. Bric-a-brac, ornaments, and elaborate 
hangings are out of place in a bedroom. 



CHAPTER XI 

THE LIVING-ROOM, PLAY-ROOM, AND WORKSHOP 

Where we live. The sitting-room, or living-room, 
is the place in the house where we really live. It 
should be made the most attractive, usable, and 
livable room in the house. Plenty of light, plenty of 
fresh air, plenty of warmth in winter time, plenty 
of comfortable places in which to sit, and the nec- 
essary tables or shelves on which to keep our work 
or our books or our pictures — that is all the fur- 
niture it needs. No matter how expensively it is 
fitted up, it is a failure if it is not cozy and usable 
and convenient for every member of the family. 

Chairs for comfort. The most essential thing in 
furnishing a living-room or sitting-room is at least 
one thoroughly comfortable, roomy, backward- 
sloping, well-cushioned, and well-fitting chair for 
each member of the family, and several more for 
guests. These chairs should be made to sit in, not 
to look at, and each should be deliberately chosen 
for an individual member of the family. The best 
way to produce a taste for reading and study in the 
family is to have thoroughly comfortable reading- 
chairs which invite you to sit down in them and 
make you content to stay in them. When a living- 
room has this equipment of chairs, it is well fur- 



84 COMMUNITY HYGIENE 

nished. The only other things really needed are one 
or two tables and low bookcases to hold the books 
that you happen to be reading, or the work that 
you happen to be doing. A few attractive pictures 
on the walls and as slight curtains at the windows 
as the conscience of the model housekeeper will 
permit complete the furnishings. 

Tables for use. The tables should be adapted 
to the size of the family and the arrangements of 
the room. If the sitting-room is also the dining- 
room, then the dining-table will make an admirable 
and roomy workbench, particularly if it can be 
mounted on real casters and rolled to one side or 
the other of the room between meals. Unless the 
room is used for a dining-room, it is usually better 
to have two or three medium-sized or small tables 
placed against the wall wherever they may be con- 
venient to receive a book or paper or piece of hand- 
work. If the living-room is also the library, which 
is the most cozy and attractive arrangement, the 
bookcases should be made low and with rather 
broad shelves. The broad top of the highest shelf, 
which should not be more than four and a half or 
five feet high, may be used for whatever papers, 
puzzles, wood-carvings, or other fancy-work the 
family may have on hand. These shelves are also 
convenient for one or two pots or vases of flowers. 
The walls above may be hung with a few interesting 
pictures which the family really like. The taste of the 
youngest as well as the oldest should be represented. 







_i 



86 COMMUNITY HYGIENE 

Carpets and rugs. Anything that looks warm 
and attractive and feels soft under the foot is a good 
floor covering. It must be remembered that the 
chief use of the room will be in the evenings after 
supper ; and the colors of the rug should look cheer- 
ful by lamplight. Any warm and cheerful color or 
combination of colors is better than dull or dingy 
hues which are chosen because they do not show 
dirt and will not fade in the sun. On the whole, a 
hard-wood or well-painted floor, covered with a rug 
or rugs, is best, because it is more easily kept clean, 
and gives less chance for the accumulation of dust 
and lint. 

There should be plenty of floor coverings, so 
that all the children — ■ and grown-ups, if they 
wish — may have abundant room to sit and play 
upon the floor with comfort. Great care should 
be taken to have the floor free from splinters, so 
that children may be safe on them even in their 
bare feet, and free from cracks and crevices, so 
that if dirt collects, it cannot accumulate in places 
where it will be hard to get at it. The floor should 
never be so brilliantly polished as to make it un- 
safe for any one to walk quickly or run across 
it. 

Sweeping and dusting. In the living-room a 
carpet sweeper should first be used to pick up the 
big dirt, and be followed by a damp or slightly oiled 
cloth on the end of a mop-stick or tied over a broom. 
The ordinary broom and feather duster should never 



PLAY-ROOM AND WORKSHOP 87 

be allowed inside the living-room. Hygienically 
speaking, they are worse than useless, for they 
whisk and whirl the dust from the floor and carpets, 
where it is doing nobody serious harm, and drive it 
into the air, to be breathed into our noses. It is 
better to have a number of small rugs than one or 
two large ones, because it is so much easier to pick 
them up and take them out of doors and give them 
the thorough beating and exposure to the sun and 
air which is really needed to make them fit to walk 
or play upon. 

Paper and paint. Both paper and paint in the 
sitting-room should have a hard, smooth surface, 
so that they may be easily wiped clean. The colors 
should be bright and cheerful to reflect the light and 
increase its health-giving and antiseptic effects. 
Even in the most beautifully built and ideally 
situated houses, it seldom happens that any living- 
room can have too much light in it, except possibly 
during a month or two in the summer. As the living- 
room is to be occupied chiefly at night, the colors of 
the paper and woodwork may be somewhat richer, 
deeper, and more decorative than those of the bed- 
rooms. For the woodwork, nothing is better than 
the natural woods, particularly of the lighter 
shades, rubbed down and oil-finished, but not var- 
nished, as this gives too glassy an effect. The 
natural patterns of the grained woods are always 
attractive, and no two pieces are ever alike. 

Elaborate designs or raised patterns upon the 



88 COMMUNITY HYGIENE 

wall-papers or paint should be avoided, because 
their principal use is to conceal dust, fly specks, and 
other dirt. It is a great hygienic advantage to have 
the walls and woodwork show every speck of dirt 
promptly. Walls should be so treated as to furnish 
good backgrounds for the few pictures hung upon 
them, and the paper should never be so obtrusive 
as to distract the eye from the more important 
things in the room. 

Unhealthful curtains. The most beautiful, as well 
as the most wholesome and permanently attractive 
pictures are those seen through the windows. The 
finest landscapes we can put upon our walls are 
those which grow outdoors; and everything which 
interferes with the free view into Nature's ever- 
changing art gallery should be removed. 

Shutters are a particularly stupid and unhygienic 
survival of the Dark Ages. They are useless as 
protection against modern methods of burglary, 
and the other bogies which they were once intended 
to keep out have melted into thin air. They shut 
out light, interfere with ventilation, and are useless 
by day and by night, except perhaps for a few hours 
in the middle of the day during the summer months. 

Blinds should be so hung that they can be put 
entirely out of sight and out of the way except when 
they are needed to shut out blazing sunlight. Only 
the lightest and flimsiest of curtains are necessary, 
for the dread that vicious or spiteful people may 
peep in and discover the secrets of our harmless 



PLAY-ROOM AND WORKSHOP 89 




HEALTH AND GOOD TASTE 



THE LIVING-ROOM 



Notice the big swinging window, the door opening out on the piazza, the comfort- 
able chair and couch, the few good ornaments and pictures, and somebody's collec- 
tion of ribbons and medals just below the shelf. Wouldn't you think that a happy 
and healthy family lived in this house? 

household life is also a survival of the Dark Ages. 
No blinds or curtains or shutters should be allowed 
for a moment to interfere with the proper ventila- 
tion of the room either day or night. That ridiculous 
craving for privacy which makes us close our houses 
at night as if they were robbers' caves is a survi- 
val of the time when our ancestors were nervous 
about prowling bears and " gobberlins." 

Nothing too good to use. This should be the motto 
of the living-room, and everything in it should be in 



90 COMMUNITY HYGIENE 

accord with the motto. We may be thankful that in 
the modern home we seldom see the formal best 
parlor intended " for company." As guests are 
entertained only at intervals, it is absurd to sacrifice, 
as often used to be done, one of the best rooms in 
the house for their occasional use. This sacrifice 
was made on the altar of our vanity and foolish 
pride. What is good enough for us ought to be good 
enough for any of our friends who really care to 
see us. 

The children's room. Every room in the house, 
except the kitchen during business hours, ought to 
be a children's room. A house should be mainly a 
place in which to raise children. Still, where space 
is available, it is a great convenience for both the 
little folk and the housekeeping authorities to have 
one room, not necessarily very large, but warm, 
cozy, well lighted, and easy to reach, devoted largely 
to the play, work, and enjoyment of children. 

The furniture should be simple, the most impor- 
tant article of it being the floor, which should be well 
warmed and covered with a soft thick rug or carpet 
thoroughly comfortable and convenient to play 
upon. The surface should not be too rough or un- 
even. Carts should wheel across it easily, and tin 
soldiers should readily stand upright upon it. The 
best covering is really one of the cork or rubber 
carpets, such as are used in hospitals, providing it is 
kept thoroughly warm by furnace or steam heat. 
There should be chairs of different sizes, and several 



PLAY-ROOM AND WORKSHOP 91 

small tables which can be readily dragged to places 
where they may be required. There should be a 
big case — half rack, half box — in one corner, 
where all the playthings may be kept at night. 
Where possible, add an inexpensive workbench or 
table, where work can be done, and a sand-box 
where cities can be built and forts constructed. 

If a room can possibly be secured elsewhere, this 
playroom should not be in the garret or in an upper 
story to strain short legs and little backs unneces- 
sarily. An important part of its equipment, where- 
ever it can be arranged, is a door with steps leading 
outdoors, and a small hallway or cloakroom just in- 
side. Here the dirt which is brought in on tiny shoesr 
and the treasures which are lugged in by chubby 
arms may be caught, before being spread all over 
the floors of the house. 

Where work is play. Every house where there are 
children in the family should have a bench and tool- 
rack. If there is no barn or shed where space may 
be found for this purpose, a part of the house should 
be devoted to it, — possibly a well-lighted, well- 
ventilated portion of the basement, or some small 
room toward the back of the house. 

The chief objection to having a workshop in the 
house is not so much the shavings, sawdust, and 
untidiness that must be made, but the noise. The 
hammer, the saw, and the file are deadly instru- 
ments to sensitive ear drums. The best arrange- 
ment is to have the workshop in a small shed, or in 



92 COMMUNITY HYGIENE 

the barn. The instinct for workmanship is one of 
the deepest and most important impulses of child 
nature. No amount of trouble and scheming is too 
great to give the boy a chance to construct things. 
He will find out more about practical mathematics 
by building a box, or a trap, or a boat, or a flying 
machine, than he will in years of textbook study 
and mechanical drawing. 

The bench and its lighting. While almost any 
kind of bench is better than none, and any sort of 
table or supported plank which is solid enough to 
hammer on and steady enough to saw and chisel on, 
will serve the purpose, it is well worth while to take 
a little trouble to make the bench fit the boy who is 
going to work at it. If there are two or three sizes 
of boy in the family, then it is a good thing to have 
two different levels, terrace fashion, at the one 
bench. Pains should be taken to place the bench 
in a good light, the best being overhead light from 
a skylight. This can sometimes be secured in a 
shed or barn. The next best arrangement is light 
coming from directly over the bench so that it 
strikes down upon the tools and the work at about 
the same angle as it is reflected up to the eye. The 
window of the workshop may face in almost any 
direction, because it is seldom used for more than 
an hour or two at a time. Where it can be secured, 
north light is the best for the bench, although, for 
the sake of the sunshine, the room should have light 
from the south or southwest by other windows. 




A REAL WORKSHOP EDUCATES THE BOV 



CHAPTER XII 

THE PORCHES 

The healthiest room in the house. The original 
porch was simply a sort of little lean-to or perma- 
nent awning over the front door to keep the rain 
from beating in when it was opened. We have 
learned how to build better, now, and, recognizing 
its possibilities, we have enlarged our idea of the 
porch. In modern families it is usually regarded as 
an outdoor living-room for use all day long in sum- 
mer and for part of the day in all but the coldest 
months. In some houses this idea is rather over- 
done, the porch being carried around so much of 
the house as to interfere seriously with the light and 
sun of the downstairs living-rooms. However, this 
difficulty can be largely avoided by making the 
porch high enough to allow plenty of light and air 
to come in during the winter, and by shutting off 
the surplus sun in summer with porch screens and 
shades. Indeed, the disadvantage of cutting off a 
certain amount of light and sun is more than coun- 
terbalanced by the opportunity to keep the windows 
open without danger of rain or snow beating in. 

The porch is particularly valuable for children, 
furnishing them with a dry floor upon which they 
can play in almost any kind of weather. The more 



THE PORCHES 95 

we live on our porches and make them a much-used 
part of the house, the healthier, happier, and more 
comfortable we shall be. 

Outdoor tables and chairs. For a long time, the 
porch was little better than a stiff, narrow, shaded 
shelf or extra-wide step in front of the house. It was 
hardly wide enough for a chair, let alone a table. If 
members of the family ventured to sit on it, they 
had to range themselves in a stiff, unsociable row, 
with their backs against the wall, and trip over one 
another's feet every time they wanted to change 
places or go into the house. 

The modern porch is built deep and wide — at 
least eight to ten feet — and is fitted up with chairs, 
tables, hammocks, and lounges just like a living- 
room in the house. The chairs and tables, of course, 
should be of some rustic or plain make, so that they 
will not be hurt by the weather if they happen to 
get wet. It is an addition to our comfort and health 
to have part of the porch arranged to communicate 
by a door with the dining-room or kitchen, screened 
from direct view of the street, and used for a dining- 
room in the summer, or at least for a breakfast- 
room. 

Insect screens and shades. This part of the 
porch should be screened with wire screening 
against flies or other insects. It is always a good 
idea to have some portion of the porch protected in 
this way, except where the manure and garbage 
heaps of the entire neighborhood are properly kept, 



96 COMMUNITY HYGIENE 

and there are no flies, and the neighboring swamps 
are drained so as to prevent mosquitoes. 

It is also a great convenience to have two or 
three hanging shades or curtains of split bamboo, 
coarse canvas, or burlap, which can be hung on 
hooks and easily shifted from one part of the porch 
to another. By means of these one can shut out the 
midday sun in summer, or shade some part of the 
porch for reading or writing, or secure privacy when 
the house is too near the street. 

The roof of the porch should be high — at least 
nine or ten feet at the free edge — in order to let 
plenty of light and air into the downstairs rooms, 
even in winter time. It is well to have most of the 
porch surrounded by a light balustrade or lattice- 
work, or even a low solid parapet, because it gives 
better protection from the weather and keeps books, 
papers, work, and toys from being blown out in case 
of a sudden wind-storm. 

The sleeping-porch. Another use for the porch in 
recent years is as a summer sleeping-room. For this 
purpose an upstairs porch or a railed-in part of the 
roof of the downstairs porch, with a canopy over it, 
is most suitable. It is a great advantage to health 
and comfort in the hot weather, and one of the best 
preventives of consumption or other lung diseases 
ever discovered. 

It is best to have a wide door opening directly 
out of the bedroom upon the sleeping-porch. If a 
severe storm comes up in the night, the bed can be 




Ill 










HOW TO SLEEP OUT OF DOORS 



98 COMMUNITY HYGIENE 

rolled back upon its casters into shelter. It is also 
advisable to have the porch surrounded with wire or 
cotton mosquito netting, so that neither mosquitoes 
nor flies will interfere with sleep and comfort. 

It is surprising how, once you have formed the 
habit of sleeping on a porch, you will want to keep 
it up until late in the fall or even early in the winter, 
and begin it again as soon as the first mild weather 
comes in the spring. No one really .knows how 
thoroughly enjoyable and refreshing sleep can be 
until he has tried sleeping in the open air. 

The back porch and summer kitchen. A most 
important part of the house is the back porch, 
which is a kind of anteroom to the kitchen. It is 
an excellent thing to have this made wide and deep 
and screened against flies or insects. Many house- 
hold tasks in summer time can be performed here* 
in the open air. A well-screened back porch where 
the refrigerator can stand, where beans and peas 
can be prepared, and where fruit and vegetables 
can be kept, is as great an advantage to the health 
of the family as a front porch is to its comfort and 
enjoyment. It should be provided with a table and 
some plain chairs and utilized as a summer kitchen 
and workroom. One end of it may be equipped for 
a children's playroom in pleasant weather. In the 
hot summer weather a big tub placed in the middle 
of the children's porch and half filled with cool 
water is a comfortable impromptu bathing-beach. 




WRONG AND RIGHT BACK PORCHES 

It costs only a few dollars to furnish a living-porch, and the comfort and health it 
brings to the family is worth many times the money. 



CHAPTER XIII 

THE BARN AND THE OUTBUILDINGS 

Outdoors with a roof on it. The barn is one of 
the most interesting and useful parts of the home- 
stead. In the country, of course, it is the " business 
end" of the establishment; and a thrifty farmer 
would consider himself badly off if his barn were not 
at least twice the size of his house. But even where 
it has shrunk to the modest proportions allowed by 
a town lot, with accommodations for a single cow 
and a pair of horses, a pig, and a score of chickens, 
it still remains an important factor in the health 
and comfort of the family. The child who has not 
had some sort of barn to play in while he was grow- 
ing up, has been robbed of one of his most precious 
birthrights. 

Next to out of doors, a barn is a boy's chief play- 
ground. A boy who has parents who can read and 
write, a barn, and a garden will be fairly educated 
whether he ever goes to school or not. There is 
always something to do in a barn. There is corn 
to be given to horses and cattle, there is hay to be 
thrown down for them, stalls to be cleaned and 
bedded down; there are horses to be curried, cows 
to be milked, chickens to be fed, eggs to be gathered, 
corn to be shelled, and harnesses to be dusted and 



BARN AND OUTBUILDINGS 101 

oiled. A barn has somewhat the same attraction for 
a boy that a doll's house has for a girl. The lessons 
of responsibility for the care of others, of pleasure 
in seeing animals thriving and comfortable, of regu- 
lar duties and constant watchfulness, of feeling that 
you are of some use in the world, are among the 
most valuable in life. 

The haymow and hay chutes. In addition to all 
this feeling of occupation and accomplishment, the 
barn is the finest play-place imaginable, especially 
on rainy days. In spite of the fact that certain parts 
of the old-fashioned barn were dirty and unhealth- 
ful, on the whole it was a wholesome place for 
vigorous play. The old-fashioned barn was so gen- 
erous in the matter of open doors and windows, or 
so loosely built, that it was self-ventilating. Al- 
though there were various chutes, openings, and 
perpendicular ladders where life and limb might be 
risked, and plenty of places where the dirtiest kind 
of dirt gathered, the percentage of accidents was 
very small. For the most part, the modern barn is 
a cleaner, wholesomer place for children to play ; but 
it occasionally suffers from the defects of this very 
virtue, and is built so much like a house that it is n't 
ventilated properly, or is kept in such tidy condi- 
tion that children are discouraged from playing 
there for fear of " making a muss." 

The indoor play-room. It should be remembered 
by parents that children, if not the most profitable, 
are by far the most valuable and important stock 



102 COMMUNITY HYGIENE 

that can be raised in a barn; and that the barn or 
stable should afford a place for play, amusement, 
and training for the children of the family. Some 
special room in the barn should be set aside as a 
play-room for their use, where they can have their 
toys and little tools. There may be tables and stools 
and a doll's house for the girls, a tool-rack for the 
boys, and plenty of odds and ends, such as broken 
boards, old furniture, boxes, buckets, tins, scrap 
iron, and all the varieties of delightful junk that 
boys and girls need in their business of construct- 
ing a new world in their plays of make-believe. 

The stalls and their cleaning and lighting. In the 
main, the better a barn is kept for its own purposes, 
the better play-place it is for children. The old 
barn was dark in the corners, particularly around 
the granary and the harness-room, or up under the 
eaves over the haymow. It was full of dirt and dust, 
which was not exactly wholesome to get into 
scratches or inhale into noses and lungs. It was this 
same dust which, as we have seen, made trouble 
when it got into the milk. The modern barn, with 
its abundance of clean, well-kept windows, and 
floods of light everywhere, its smooth walls and 
tight floors which are swept and kept free of dust, 
is a great improvement upon the old, loosely built, 
half-lighted structures, where you could nearly suf- 
focate yourself at any time by jumping up and 
down on one or two of the loose boards and start- 
ing the dust flying. 



BARN AND OUTBUILDINGS 103 

The old-fashioned cow stalls and horse stalls, 
floored with rough, knotty planks laid often upon 
axe-trimmed logs for floor beams, could not be kept 
decently clean and free from odor. The floor was 
not closely laid ; indeed, very frequently a gap was 
left between the planks at its edge, in order to 
allow for the drainage of moisture and the scraping 
through of the finer parts of the manure dust. That 
meant that filth gathered under the whole floor of 
this part of the barn. 

In the modern barn the stalls are floored with 
concrete, or else with heavy matched or closely laid 
boards, coated over with tar or pitch, which makes 
a smooth waterproof surface. This flooring is laid 
on a slight slant to a shallow gutter running just be- 
hind the heels of the animals, and the gutter again 
has a gentle slope in order to carry away all drainage. 
This drainage is usually delivered in a tank under 
the floor of the barn, from which it can be pumped 
into a hogshead upon a wagon and carried out into 
the fields where it makes a most valuable fertilizer. 
Where the barn stands high enough at the down- 
hill end, the gutters discharge the fluids and the 
wash-water from the floor of the barn directly into 
a portable tank on wheels, which can be hauled out 
to the fields as quickly as it fills. With this kind of 
floor, by using chaff or sawdust for bedding with a 
little land plaster to absorb the fluids and odors, the 
barn can be kept as clean, and almost as odorless, 
as a workshop or woodshed. Milk produced in such 



104 COMMUNITY HYGIENE 

a barn as this, with no dust overhead, and no dirt 
from the floor on the flanks and udder of the cow, 
will be clean, sweet, and wholesome. 

The chicken-house. The chicken-house is another 
portion of the homestead which, whether it be a 
part of the barn or a separate building by itself, 
requires careful sanitary inspection. The manure 
which accumulates in the henhouse, although small 
in amount and easily handled, becomes so offensive 
from the large amount of ammonia which it gives 
off that special steps must be taken toward keeping 
it cleaned out. 

The floor of the chicken-house, or at least of that 
part of it which is used for roosts and nests, should 
be laid in cement or floored with some smooth, close- 
fitting planking, tarred or pitched, or otherwise 
coated so as to make it easily cleaned. With this 
sort of surface, and a broom or hoe, it is easy to 
remove the manure which is so valuable a fertilizer 
that it pays to save it properly. 

The roosts also should be coated in some way, 
and the walls of the house, and the tops and sides 
of the nest-boxes, made smooth and even, so that 
they can be readily whitewashed. They should be 
brushed down with a broom at least once or twice 
a month, and whitewashed at least twice a year. 
These measures are useful, not merely in preventing 
the henhouse from becoming offensive, but also be- 
cause no lodging-place is left for one of the great- 
est enemies of all poultry, fleas. If the henhouse 



BARN AND OUTBUILDINGS 105 

be kept as described, and is occasionally sprinkled 
with some insect-destroyer, there will be little risk 
of the flock being infected with these troublesome 
parasites. The interiors and floors of the nest-boxes 
should also be made smooth and be whitewashed, 
and the material used for lining the nests should be 
burned at least once a month during the summer 
and replaced with a fresh supply. This will destroy 
any parasites that may have established them- 
selves, and will help to keep the flock in good con- 
dition. The henhouse kept in this way will be al- 
most devoid of offensive odors, will make the birds 
healthier, and more thrifty, and will produce a 
better yield. 

The pig and his pen. If the homestead is so 
situated that pigs can be kept, they should be cared 
for in much the same way. The pig is a much- 
maligned animal. Though he occasionally takes de- 
light in wallowing in a pool of soft mud and water, 
as most of us have done in creek or river in our 
boyhood, he is not naturally a dirty animal. Those 
who have given him a fair chance say that he enjoys 
being clean, and will meet you halfway in your at- 
tempts to improve his sanitary condition. At all 
events, although pigs like a certain amount of clean, 
fresh dirt to roll and root in, they do much better, 
are less subject to disease, and give better returns 
on their food rations, if they are kept on a clean, 
firm floor, with clean, dry beds, and if they are 
given such food that their troughs can be kept 



106 COMMUNITY HYGIENE 

clean. Slops are about the poorest diet that a pig 
can have, and he is supposed to like them only 
because he will eat them if he can't get anything 
else. 

The modern pigpen used by breeders of pedi- 
greed swine has a cement floor which can be washed 
down readily, and a small bed or sleeping-platform 
of boards which is supplied with a moderate amount 
of clean, dry litter. The floor of the pen is swept or 
washed down every day. The corner in which the 
trough is kept is close to the drainage opening. The 
trough itself is thoroughly cleaned out at least once 
a day. The pigs are curried daily with a stiff brush 
and frequently brushed with a broom, and the 
place is as free from odor as a haymow. They have 
a well-drained and cleanly kept dirt yard in which 
they are allowed to run when the weather is suitable. 
Pigs kept like this seldom or never get cholera. 

The manure heap, good servant but bad master. 
A valuable but troublesome product of the barn is 
its manure heap. On account of its odor and offen- 
sive appearance, its danger as a source of flies, and 
the annoyance of handling it, manure is more or less 
of a nuisance. It would be altogether a nuisance if 
it were not for its value as fertilizer. Luckily, the 
methods of handling which preserve its fertilizing 
value are also those which make it less offensive 
and dangerous. 

In other words, the sooner that the manure can 
be hauled out on the soil and plowed under, the 



BARN AND OUTBUILDINGS 107 

more perfectly will all of its fertilizing value be 
preserved. Fresh or raw manure, however, hurts 
the roots and leaves of growing plants. Hence it 
cannot be spread upon the soil which is under crop. 
It must undergo a thorough rotting and mellowing 
before the rootlets can use it. Therefore it is well 
to have, all through the summer season, some area 
of ground either lying fallow or just cleared of a 
crop, where the manure can be spread upon the 
soil and plowed under; or else to have a manure or 
compost heap, either in a shed near the barn closed 
in and screened thoroughly against flies, or else a 
quarter of a mile away, where, by mixing the manure 
with borax or sulphate of iron, it can be kept com- 
)aratively free from the fly maggots. 

The old method of handling manure was bad both 
from the point of view of economy and of health. 
Throwing it out of the rear door of the barn, or 
down through a hole in the floor, and allowing it 
to pile up was a wasteful method. It was exposed 
to every storm, and the rain or snow water soaked 
down through it, washing away anywhere from 
fifteen to fifty per cent of its fertilizing value. As 
soon as the warm weather came, the flies swarmed all 
over it, laying their eggs in it by the thousand, and 
their offspring rose in clouds to make life a burden 
for every living thing within three hundred yards. 

The modern method of handling manure is either 
to have standing at the back of the barn a wagon 
with a box-bed, into which the manure is thrown to 



108 COMMUNITY HYGIENE 

be hauled out on to the land as fast as it is filled, or 
else to have it thrown into a tight-walled shed 
which preserves all the fertilizing value of it. This is 
fitted with a screen over the windows, and a swinging 
plank or wire-screen door, which will allow the 
manure to be thrown into the box, but falls back of 
its own weight and shuts out the flies. In towns and 
villages the manure may be thrown into a box and 
then taken away by wagons which call for it every 
ten days, and every week in hot weather. The box 
should have a tight floor to prevent flies breeding 
underneath it, and there should be an opening to- 
ward the light, over which is tightly placed a fly- 
trap to catch any flies which may get into the box. 
The drainage of the barnyard. Any one who 
expected a barnyard to be anything but muddy and 
ill-smelling in the fall and winter used to be regarded 
as a finical person. The amount of stock kept, the 
careless way of handling manure, and the utter 
absence of proper drainage made the average barn- 
yard in winter and spring a foul-smelling bog. Most 
of us can remember the chain of stones which ran 
from the house to the barn door, to be used as 
stepping-stones across the quagmire in early spring. 
This condition, however, has been greatly improved. 
The cause of the trouble was that, while the farmer 
took great pains to drain and underdrain his fields 
where his crops were to be grown, he never dreamed 
of spending money for drainage about his barnyard 
or in his feed-lots. A few hundred feet of tiling, 



BARN AND OUTBUILDINGS 



109 




A DISGRACE TO THE CITY 

This heap of decaying garbage and trash lies at the entrance to a tenement where 
coats and artificial flowers are made. What do you think about the health of the 
people who live there ? What do you think about the city garbage collector's duty? 

costing not more than twenty or thirty dollars, laid 
around the south and west sides of the barn, and 
carrying the rainwater from the ground surface and 
roofs out to the side of the nearest hill or the bank 
of the nearest stream, will make all the difference 
between filth and cleanliness. By taking a little 
trouble to grade the surface of the barnyard and 
feed-lots so that they will slope gently toward a 
central point, where a grating connecting with the 
drain can be put in, and by hauling a few loads of 
gravel or ashes during the slack season to coat over 
the surface, a barnyard and even' a feed-lot may be 
kept clean, dry, and wholesome. 



CHAPTER XIV 

THE LOT AND GARDEN 

The world with a fence around it. Next to the 

house and barn, the most important spot in the uni- 
verse is our garden and yard. It is the garden and 
grounds which give to a home half its beauty, pro- 
vide it with its sunlight and fresh air, and furnish a 
place for rest and recreation in the open air. While 
a garden can be laid out in a hundred different ways, 
there are two or three simple principles which have 
to be followed in practically all cases. 

It should be deep enough at front and back, and 
wide enough at the sides, to allow plenty of fresh 
air to circulate on all sides of the house in all direc- 
tions of the wind, and to have plenty of light at all 
hours of the day and at all seasons of the year. Its 
surface should be so planted as to be free from dust 
or dirt, and so graded and drained that water will 
not stand there or soak in under the house. It should 
be made as attractive as the soil, climate, and cir- 
cumstances will permit. Any piece of ground which 
fulfills these requirements is a good and satisfactory 
place for a healthy life. Any size, shape, arrange- 
ment, or method of planting or treating which inter- 
feres with these requirements is bad from the point 
of view of health and comfort. 



ii2 COMMUNITY HYGIENE 

The front yard and its flowers. Almost every lot 
is roughly divided into three parts — the front yard, 
the house and its borders, and the back yard. The 
front yard is generally made ornamental and the 
back yard is more or less useful. Sometimes it is 
more accurate to say that the front yard is tidy and 
the back yard untidy; but this occurs less and less 
frequently as people in general learn the need of 
sanitation. 

Though there are a hundred different ways of 
beautifying the front garden, its attractiveness is 
best secured by grass or turf. Flowers and shrubs 
are beautiful, but their beauty often lasts only a 
few weeks or months, while the fresh green grass is 
a constant joy to the eye anywhere from six to ten 
months of the year, according to the latitude. 
Grass has another advantage, from a sanitary point 
of view. It forms a practically dust-free and mud- 
free coating all the year round. From it nothing 
blows into the house, nothing is carried on to the 
porches and the floors. With this soft green carpet 
as a background, beautiful effects can be produced 
by flowers and shrubs and trees. Flowers should be 
used chiefly to heighten by contrast the greenness, 
softness, and smoothness of the turf, although if any 
one likes a great variety of flowers, there is no hy- 
gienic reason why he should not grow them. 

The planting and training of trees and shrubs, 
however, should be kept strictly within certain 
limits. They should never be allowed to grow to 






THE LOT AND GARDEN 113 

such a size as to cut off any considerable share of 
light and sun from the house or windows. The habit 
of allowing trees or vines to grow close to the side of 
a house is undesirable from a sanitary point of view. 
Unless they are carefully trimmed, they darken the 
rooms, make the house damp, rot its shingles, and 
block up its eave-spouts by the leaves, twigs, bark 
scales, insects, etc., which they perpetually shed 
upon it. Shrubbery more than five or six feet high 
should not be allowed to grow against the walls of 
the house, as it makes them damp and furnishes a 
home for insects. Neither trees nor shrubs should 
be planted so as to interfere with the view from any 
of the windows of the house, unless they are placed 
at a considerable distance to hide some less desirable 
feature of the landscape. 

The back yard and its cans. Unfortunately, the 
back yard is often used simply as a kind of conven- 
ient dumping-ground for odds and ends. Instead, it 
should be made one of the most useful and attrac- 
tive portions of the lot. Where it is large enough, it 
can be used as a vegetable garden. Every house 
should have a few beds of the commoner vegetables, 
and as many rows as possible of the hardier varieties 
of fruit. The exercise of working in the garden is 
wholesome and healthful. Children delight in hav- 
ing a little piece of ground of their own, where 
they may plant anything they please and watch it 
grow. A tract of ground where vegetables and 
flowers can be grown and drainage or digging and 



ii4 COMMUNITY HYGIENE 

building operations carried out is of great educa- 
tional and hygienic value. 

The garbage-can and its visitors. In the country 
and parts of towns where chickens and pigs are kept, 
the garbage problem may be solved by carrying 
the food waste two or three times a day directly 
from the kitchen to the chicken-yard or pigpen. 
Where this cannot be done, a suitable can should be 
provided, large enough to hold twenty-four hours' 
garbage. It should be well galvanized, so that it 
will not be attacked by the acids in food and will 
keep a smooth surface that can be readily cleaned. 
It should be heavy enough to stand considerable 
wear and tear, and fitted with a tight lid which will 
shut in odors and keep out flies. The old swill-pail 
was a sanitary nuisance. It was usually too big and 
too clumsy to be conveniently emptied or easily 
cleaned. Day after day the food and slops from the 
kitchen were dumped into it and then scooped out of 
it into buckets to be carried to the pigs or chickens. 
There was always a layer left at the bottom, and 
sufficient scraps sticking on the sides to sour and 
putrefy. A constant fermentation and souring went 
on in the contents of the tub. It was a free-lunch 
counter for all the swarms of flies in the neighbor- 
hood that fed eagerly over it, swarmed into the 
house and over the tables for dessert, and then 
went to lay their eggs in the near-by manure heaps. 
Another group of visitors were the stray cats and 
dogs of the neighborhood, most of whom had a regu- 




THREE DEADLY DANGERS 
The manure-heap, the outhouse near the well, and the open sewer are a disgrace 
to any community. They cost in medicine, doctor's bills, and human lives far 
more than the operation of sewer and street-cleaning systems. 



n6 COMMUNITY HYGIENE 

lar lunch route of swill-tubs and garbage-barrels. 
They pulled out pieces of food that they could not 
eat and dropped them on the ground to putrefy and 
attract fresh swarms of flies. In many cases the 
rats of the neighborhood came to the garbage- 
barrels to feed and drag pieces of food away under 
the floors of the buildings to putrefy and give off 
unwholesome odors. 

Garbage-burners. In nearly all towns and cities 
carts now come around at least once and some- 
times twice a day to collect the garbage. In many 
small towns, villages, and even country districts, 
where chickens and pigs are not kept on the prem- 
ises, one may arrange with a neighbor who has 
chickens or pigs to come and gather up the garbage 
for the sake of its food value. Wherever neither of 
these methods can be depended upon, it is well for 
each house to provide itself with some sort of small 
garbage-burner or rubbish-furnace. This need be 
nothing more than a simple sheet-iron box with a 
grating inside upon which the garbage is placed and 
under which a fire is built; or an old disused stove 
may be used, or an oven-like structure of bricks or 
cement. The garbage should be thoroughly drained 
over the sink or into the sewer, to remove the moist- 
ure and make it burn more readily. There is usually 
fat or starch or meat enough in most garbage to 
furnish a fair amount of fuel. Where garbage is to 
be disposed of in this way, it is well to have a kero- 
sene can near the garbage-barrel and pour a table- 



fa 




- 






W .5 3 



a a 

6'5 



W j3 d 

■- 1 M dj 



^S 



n8 COMMUNITY HYGIENE 

spoonful or more over each deposit of garbage. This 
prevents the flies from feeding on it and laying their 
eggs in it, and kills any maggots that may be develop- 
ing in it. Also it makes the refuse easier to burn. 

Any sort of waste material, such as shavings, 
straw, odds and ends of wood, old newspapers, 
broken boxes, and so forth, or a barrel of crude oil 
which costs little and lasts a long time, may be 
used in burning the garbage. A considerable part of 
the coal in ordinary ashes from a house still remains 
unburned, and if a sifter or screen be provided, so 
that the dust of the ashes can be screened out of it, 
the coarse part may be mixed with the garbage and 
furnish a considerable amount of the heat needed to 
burn it. There should be such a burning-place as 
this in every back yard, where all kinds of trash, 
sweepings, scraps, and all waste which will not go 
into the sewer or the garbage-can may be destroyed. 

Waste water and the well. In those households 
which draw their water-supply from a well, it is usu- 
ally situated in the back yard. This is convenient to 
the kitchen where the water is chiefly needed ; but if 
any wash-water, or dish-water, or scraps of garbage, 
are thrown out to litter the surface of the back yard, 
they are apt to be washed down into the soil by the 
rains and ultimately to seep their way into the well. 

In most soils where there is no layer of rock or 
waterproof clay or hardpan close to the surface, a 
well will drain an area of soil in every direction of 
from two to four times its own depth. Practically 



THE LOT AND GARDEN 119 

every kind of dirt which is allowed to gather in an 
ordinary back yard, including the refuse from the 
stable, henhouse, and pigpen, is liable to be washed 
into the well, especially during wet weather. Fortu- 
nately, it is now the habit to put the barns, pig-pens, 
sheds, and outbuildings a fair distance away from 
the house in order to avoid flies, odors, and seepage. 
The yard and grounds for at least twenty to forty 
paces around the well in every direction should be 
kept scrupulously clean. If there is no regular sewer, 
a pipe should be laid from the kitchen sink and the 
back door, running out either into the nearest field, 
or to the side of the nearest creek or gully. Where 
this cannot be done, the pipe should run into some 
patch of porous cultivated ground where the roots 
of the crops or of the trees will break up the waste 
matter and make it harmless. The upper three or 
four feet of the wall of the well should be thoroughly 
cemented, both inside and out, to prevent the 
washing of the surface soil or dirt into the water. 
The top of the well should be roofed over with a 
wide, firm platform of close-fitting matched boards, 
which should be well painted and leaded along their 
edges, so as to keep out waste water. This well- 
cover, or platform, should be so arranged that it can 
be lifted up at least once a month and the well 
carefully examined to see whether any rats, mice, 
or squirrels may have bored their way through the 
wall of the well and fallen into the water, or whether 
any frogs or toads have worked their way into it. 



120 ' COMMUNITY HYGIENE 

Most animals and insects are fond of water. It is 
surprising how many different kinds of creatures 
and bugs and crawling things will manage to find 
their way into a well, and their decaying bodies will 
often make the water bad to drink. At least once a 
year every well should be pumped dry, opened, and 
thoroughly cleaned. In spite of all care, a certain 
amount of dust, dirt, leaf mould, and insects will fall 
into a well and make a deposit of mud or sludge. 
This should be thoroughly cleaned out and the well 
scraped down. After the cleaning and before the 
well is again used, the water should be allowed to 
come in two or three times, each time being pumped 
out. If the well is deep, it is always safest to lower 
a lighted candle or lamp to the bottom before lower- 
ing any one into it to clean it out, because the vege- 
table matter which grows around the walls and falls 
into the bottom of a well often decays and gives off 
so much carbon dioxide as to make the air danger- 
ous to breathe. If the well is carefully protected, 
the slops and waste waters carried away in a short 
drain at least forty or fifty yards from the well, and 
the vault privy thoroughly cemented, made water- 
proof, and emptied at regular intervals, a perfectly 
safe and wholesome supply of drinking-water can 
be taken from a well in the country or village. In 
towns, however, it is practically impossible to be 
sure that all sorts of leakage and contamination are 
avoided, and surface wells should never be depended 
upon for a drinking-water supply. 



SECTION III -HEALTH IN THE SCHOOL 

CHAPTER XV 

WINDOWS AND DOORS 

The price we pay for shelter. When men first 
began to build houses, they were merely trying to 
make a place where they could sleep at night or take 
shelter in the daytime when it rained. Indeed, the 
first houses were not built at all, but were caves in 
the side of a hill or holes in the face of a cliff which 
primitive man dug out larger and protected with a 
curtain or door across the front to keep out the wind 
and rain. They were much like the playhouses which 
boys delight to scrape out in the side of a bank. 

Then men learned to build rough shacks of 
branches and reeds and grass out in the open, and 
by and by they managed to make a roof tight enough 
to shed rain. When they could build a warm dry 
hut, they could live where they pleased. By leaving 
a hole in one side big enough to crawl through, but 
small enough to be closed at night with a slab of 
stone or log of wood, they kept out snakes and wild 
beasts and thought they had a house to be proud of. 
However, to protect themselves from weather and 
wild beasts, they had to sacrifice light and air, so 
they still spent most of their time and did all their 



122 COMMUNITY HYGIENE 

cooking out of doors. Even to-day, with all our 
improvements in house-building, we still must lose 
some of our light and air when we go indoors. 

Holes for light, windows. It was hundreds of 
years after man reached the stage of hut-building 
before houses became much more than dark, uncom- 
fortable huts, with only one small door. There was~ 
no iron for hinges or locks and bolts. There were no 
windows, because if holes were cut for air, they let 
in cold at night, and rain and snow whenever the 
weather was bad. As tools were invented and 
improved, huts were made somewhat bigger and 
more convenient. The fireplace was moved indoors 
by the simple process of laying a crude stone fire- 
place in the middle of the room and leaving a hole 
in the roof for the smoke to get out. It is hard to 
believe that our ancestors ever lived so roughly and 
inconveniently as this, yet barely a hundred years 
ago one of our greatest men, Abraham Lincoln, was 
born in a cabin little better than this. Indeed, up 
to two or three hundred years ago, the houses in 
which most people lived were dark and dirty. Only 
the very rich could buy glass, and most people 
had no substance which would keep out rain and 
cold and at the same time let in light and sun. The 
windows had to be small and few to keep the rooms 
warm and dry in cold weather. Even well-to-do 
people could afford only small window frames with 
thin strips of oiled paper or cloth which let a little 
light filter through. 



WINDOWS AND DOORS 



123 



When we first began to make glass, we knew how 
to make it only in small, thick, lumpy pieces, which 
had to be held together with strips of lead in order 
to get a pane of moderate size. Windows were then 
pieced together like the stained glass in modern 
church windows or in lattices. Later we learned to 
blow glass so that we could get flat or curved pieces 
four or five inches square, and these were made into 
small window panes. It was not until fifty or sixty 
years ago that we were able to get clear, smooth 




trtesy Soc. ft 



Control of Tuberculosis, Boston 

NAIL-BRUSH DRILL IN SCHOOL 



Clean hands make clean work, and clean fingernails prevent hangnails. Many 
schools now have a nail-brush drill two or three times a week, and sometimes every 
day. 



124 COMMUNITY HYGIENE 

glass in panes more than eighteen inches square, 
except at a very high price. The large plate-glass 
windows that make a room almost as light as out- 
doors have come into ordinary use only within the 
last thirty years. But these beautiful transparent 
windows of ours, though they let in the light, still 
keep out the air. We don't open them half as often 
as we should, because we have still the cave dweller's 
dread of the cold or rain which used to come in when 
the shutter in the hut was left open. 

Why our ancestors made doors. For a long time 
we made the doors of our houses much too small and 
had too few of them, because in the beginning they 
were simply a slab of bark or slice of tree-trunk, and 
so the openings had to be kept as small as possible. 
Besides, we had such poor tools and hardware that 
doors sagged on their hinges if they were made large ; 
and they fitted so badly that wind and rain came in 
around the edges of their casings. A door was a per- 
manently weak spot in the wall of the house. Even 
to-day, when we have learned to make hinges that 
will swing a ten-foot door as easily and smoothly as 
the old ones did a five-foot one, and when we can 
make doors fit as tight as a trunk-lid, we don't put 
enough of them in our houses or our schoolrooms. 
There should be at least two doors in every house or 
schoolhouse. Four are better. There should be at 
least two in every room, in order that we may get 
in and out quickly in case of fire or other danger, 
and also air the room thoroughly. The outside doors 



WINDOWS AND DOORS 125 

of schoolhouses should always be built to swing out- 
ward so there may be no danger of their getting 
jammed shut. There should also be a " panic bar," 
or long handle, running across the door, which, 
when pushed against at any point, will immedi- 
ately turn the latch and let the door swing open. 

How to use our eyes. The main purpose of let- 
ting light into our rooms and houses is that we may 
use it to see by ; although it is also valuable because 
it kills germs and molds and putrefactions of all 
sorts. It takes plenty of window space to let in 
enough light to read and work by comfortably. 

In schoolrooms the area of the windows added to- 
gether ought to equal about one fifth or one fourth 
of the size of the floor. Every schoolroom should 
have windows in two sides of it. This makes the 
room very much easier to ventilate, and enables 
every pupil to have plenty of light coming from the 
right direction when he is at his desk or at the 
blackboard. If bright light shines directly into our 
eyes, it tends to dazzle us so that we don't see 
clearly. The best arrangement is to have the light fall 
upon the book or paper from over the left shoulder. 
When it does this, the rays of light fall upon the 
page we are reading and then are reflected back to 
our eyes at an angle that enables us to see clearly 
without dazzling us. It is better to have the light 
come over the left shoulder because if it comes over 
the right shoulder it throws the shadow of the pen 
and of the hand upon the paper, 



126 COMMUNITY HYGIENE 

If the windows are at one side and at one end 
of the room, the desks ought to be arranged with 
their backs toward the side or end which has the 
windows in it. This makes it a little hard for the 
teacher, if she likes to have her platform facing the 
pupils ; but she can usually protect herself by means 
of shades or a screen, or put her desk, say, at the 
middle of the side of the room. The windows should 
be provided with roller shades of some dark color, 
such as dark-green or dark-brown, so that if the sun 
shines in too brightly at any time of the day it can 
be prevented from shining into the faces of the 
children or on the pages of the books. When the 
desks are arranged to run the long way of the room, 
the shades can be pulled down on two or three of 
the windows farthest toward the front, so as to 
keep the light from striking directly into the faces of 
any of the pupils. Carefully arranging the seats and 
adjusting the blinds or shades of the windows will 
prevent a great deal of strain on the eyes in school 
work. 

The blackboard as a rule should be on the side or 
sides of the room which have no windows. If it is 
necessary to place the blackboard on the window 
side of the room, the shades should be pulled down 
on that side when the blackboard is in use, so that 
the light will not glare directly into the eyes of the 
children when they are working at the board. Even 
if the light from the other sides of the room is not 
quite so bright, it will strain the eyes of the children 




Courtesy Russell Sage Foundation, N.r. 

WHOLESOME WORK IN THE SCHOOL GARDEN 
Fine vegetables and healthy children are raised i" these school gardens. 



128 COMMUNITY HYGIENE 

much less. By making the figures and outlines 
larger, there will be no difficulty in seeing the work 
quite plainly and easily. 

Why we need change of air. Even with the largest 
and most beautiful windows placed upon two sides 
of a room, it is hard to keep indoor air as fresh and 
wholesome as that of outdoors. The air in any room 
will begin to be hot and stale after an hour or two. 
Especially in a schoolroom, where there are twenty 
or thirty persons each breathing twenty times a 
minute and perspiring all the time, it quickly begins 
to smell stuffy. Once every hour at the close of some 
recitation period, it is best to throw windows and 
doors wide open and let the pupils march around the 
room several times, or stand up and sing, or go 
through some light gymnastic or calisthenic move- 
ments in the aisles for five or six minutes. This 
changes the air in the room and in our lungs, sets 
the blood to circulating vigorously in our veins, 
takes the kinks out of our shoulders, and the cob- 
webs out of our brains. At the end of two hours we 
usually have a recess of from ten to twenty minutes, 
giving time to go out of doors and have a good 
scamper around the playground. It is a good thing 
to make several changes each day to shops or work- 
rooms in addition to the recesses in the open air. 
This gives us a change of air and exercises every 
part of our brains and bodies. 



CHAPTER XVI 

FURNACES, STOVES, AND REGISTERS — HEATING 
AND VENTILATING 

Why we need warmth. The main reason why we 
need warmth indoors is that we have acquired the 
habit of sitting still when we work and using our 
brains instead of our muscles. When we worked 
hard all day long in the woods or in the fields, went 
to bed with the chickens, and slept all night under 
mats or deerskins, we did n't need much fire in the 
hut except for cooking purposes. But when we began 
to sit still and think or read and write most of the 
day, then we needed a good fire to keep us warm. 

When we use our muscles, we burn up a great 
deal of food and waste, and this makes us warm 
Also the heart beats fast and drives the hot blood 
all over the body and keeps our skins warm and 
glowing. Though the brain needs fuel to work with, 
it does not require a quarter as much as our muscles 
do, and when we work with our minds we are not 
manufacturing much heat. Our hearts beat more 
slowly. The blood tends to move quietly in its 
channels through the interior of our bodies instead 
of rushing to the surface. Our skins begin to be cool 
and pale, and unless the room is comfortably warm, 
we soon begin to feel shivery. 



130 COMMUNITY HYGIENE 

Making our own heat. Even when we are sitting 
perfectly still, our bodies are still manufacturing a 
fair amount of heat, particularly in our great three- 
pound sugar factory, the liver. The heart in its 
steady pumping burns up a good deal of fuel, and 
also gives off heat. Even if the air about us is 
twenty-five or thirty degrees below that of our nor- 
mal body heat, we can still manage to feel com- 
fortable. As our natural body heat is about ninety- 
eight and a half degrees (98.6), we must have the 
air around our bodies somewhere about seventy 
degrees if we want to keep comfortable while we are 
sitting still. Warmth in a house is not a vital ne- 
cessity like food or water or air, but it is important 
for our comfort. We cannot fix our minds on our 
books when our feet are like ice ; or write or do sums 
or draw with fingers that are stiff with the cold. We 
need about sixty- five to seventy degrees of heat for 
comfort, but we can exist without serious risk to 
our health if the temperature is only fifty-five or 
sixty. 

When coolness helps. Remember it is necessary 
to keep up this sixty- five to seventy degree tempera- 
ture only when we are studying or writing or sitting 
still after meals. If we are moving about actively 
at any sort of indoor work, we feel warm at five or 
even fifteen degrees less; and when we are covered 
up in bed we can let the temperature go down to 
fifty, forty, or even thirty, without any injury. In 
fact, we shall feel all the brisker for it when we 



HEATING AND VENTILATING 131 

wake up in the morning. Remember that though it 
is uncomfortable to be not quite warm enough, it is 
not actually unhealthful if we are in fairly vigorous 
condition; but to be even a little too warm is not 
only much more uncomfortable, but a positive in- 
jury to our health. The room which is a little too 
hot is doing you positive harm, and you should 
throw open the windows at once and let in the cool, 
fresh air from outside, even if it may seem a little 
chilly for the moment. The best temperature is one 
that you do not notice at all ; but it is always safer 
to have the air of a schoolroom a little too cool than 
a little too hot. Our best mental and muscular work 
is done in air which feels brisk and fresh and a little 
cool. 

How air moves. While warmth above fifty de- 
grees is a matter of comfort, air is a matter of life 
and death. One of our most troublesome problems 
of indoor sanitation is the difficulty of securing 
warmth and fresh air at the same time. As we have 
already seen, when air is heated, it expands. Ex- 
pansion makes it lighter, and it tends to rise sky- 
ward, where its heat does n't do us any good, unless 
we put a cover over it to hold it down. The roof of a 
house or the ceiling of a room acts as such a cover, 
and it does n't take long for fire in a stove to heat 
all the air in a room if the doors and windows are 
all shut. Meantime, the people in that room are 
pouring into it their hot and steamy breaths, as well 
as the perspiration from the warm surface of their 



132 COMMUNITY HYGIENE 

bodies, and the air soon begins to feel hot and stuffy. 
If we throw open the windows or the door, the hot 
air instantly rushes out and up to the clouds, and 
the room is filled again with cold air from the out- 
side. We say " br-r-r-rr! " and shut the windows 
quickly. By the time we have cooked this fresh 
roomful of air to a comfortable temperature, it be- 
gins to become foul and stuffy and we have to let 
it out again. There is a constant seesaw all day long 
in cold weather between coolness and warmth, fresh 
air and foul. 

Second-hand air. The best we can do is to work 
out a compromise between ventilation and warmth. 
Even the best arrangement possible must be con- 
stantly watched, changed, and adjusted every hour 
or two according to changes in the wind and the 
weather or time of day. It is well worth all the 
trouble that it takes. 

The scheme which usually works best is to let the 
hot second-hand air escape gradually, a little at a 
time, and let in the cold outside air slowly enough 
so that it has the chill taken off it before it strikes 
us. Where the room is properly supplied with win- 
dows on two or more sides, keeping several of them 
open at the top, varying according to the direction 
of the wind and the coldness of the day, will usually 
give a good working result. Indeed, no better 
system of ventilation has yet been invented. If this 
method is supplemented by throwing wide open 
doors and windows and airing the room at regular 



HEATING AND VENTILATING 133 

intervals during calisthenics and at each recess, it. 
will usually give fairly good ventilation. 

What discourages germs. To let plenty of sun- 
light into the room and keep free currents of fresh 
air constantly moving through it is the best possible 
destroyer of germs. But because an open window 
sometimes gives an uncomfortably cool draft of air, 
and because it is sometimes difficult to keep all the 
room at a uniform temperature by window ventila- 
tion, various elaborate systems of artificial ventila- 
tion have been invented. These draw in the cold 
fresh air near the furnace, warm it to the desired 
temperature, and then send it all over the building. 
It may rise by its own heat, or be driven with fans, 
or sucked through the building by fans placed at the 
other end of the ventilation pipes. These artificial 
systems of ventilation are much better than no 
ventilation at all, but need to be helped out by the 
use of open windows in order to keep the air fresh 
for children to breathe. Any so-called system of 
ventilation which demands that the windows be 
kept closed is a sanitary nuisance and a menace to 
health. 

The open window classroom. Somewhat similar 
methods work well in a good many schools to-day. 
The heating system is relied upon to keep the walls 
and floors of the building thoroughly warm and dry. 
When school session begins, the windows of the 
classroom are thrown wide open, except on the side 
toward a cold wind or a rainstorm. The children, if 



134 COMMUNITY HYGIENE 




Control of Tubcrculo: 

PREPARING THE SCHOOL LUNCH 

The white dish on the table contains baked macaroni, the teacher is stirring soup, and 
one of the girls is cutting the bread. The cost of the noon meal is ten cents. 



they wish it, are allowed to wear their outdoor coats 
or cloaks, and they are also permitted to change 
their seats and move about the room while they are 
doing their work. Recitation periods are short and 
there are a good many singing, marching, and 
calisthenic periods, with frequent recesses. The chil- 
dren are given a lunch in the middle of the morning 
or middle of the afternoon, or are encouraged to eat 
more food at their regular meals. They usually dc 
this willingly enough, because the fresh air and the 



HEATING AND VENTILATING 




Courtesy New Yorl School Lunch Committee 

EATING THE SCHOOL LUNCH 

Many cities now serve a bowl of good hot soup to school children at recess, and 
find that they do better work and lose less time from sickness than before lunches 
were served. 

moving about give them a much better appetite. 
Letting the children move about freely allows them 
to manufacture their own heat through muscular 
action, and the extra amount of food provides the 
fuel for this purpose. Careful records have been 
kept and comparisons made between rooms of a 
given grade treated in this way and others of the 
same grade in the same building in similar class- 
rooms with the windows closed, or nearly so. In 
every case it was found that the children passed 



136 COMMUNITY HYGIENE 

better examinations, made more rapid progress, and 
had fewer coughs, colds, and catarrhs in the open- 
window room. 

Open-air classes. In the schools of most of our 
larger cities now, classes are arranged to do all 
their studying and reciting in the open air. Some of 
the classes are held on a balcony, or the open roof, 
or in some specially arranged park or grounds. For 
the most part, the pupils in these classes are those 
who are either suffering from tuberculosis or are 
weak and out of health so that they are believed to 
be in danger of an attack. 

In rainy weather, the classes are held on an open 
balcony or roofed-in porch, and in cold weather the 
children are supplied with a thick, warm Eskimo 
suit with a hood, and a bag with a hot soapstone in 
it for their feet. In this costume they can sit out and 
study even in the coldest winter weather. Almost 
always their health improves greatly, they gain 
rapidly in weight, and they make more rapid prog- 
ress in their studies than do the children in the 
classes from which they have been taken in the 
schoolroom. It is believed by some of our best 
teachers that before very long nearly half of our 
school work will be done in the open air, both for the 
sake of our health and also for more rapid progress 
in school work. 



CHAPTER XVII 

THE DESKS AND BLACKBOARDS — POSTURE, 
RECITING, SINGING, AND DRAWING 

Why we sit still. We sit at desks or tables in 
school in order to do work with books and papers 
which cannot well be done standing or while moving 
about. The sooner we can get the work done and 
the less sitting still we do, the better for our health. 
The best way to avoid too much sitting still is to 
fix our minds on our work and finish it just as fast 
and as well as we possibly can. It used to be con- 
sidered necessary to spend three fourths of the time 
in school sitting at a desk. Now many of our best 
schools devote only about one third of the pupil's 
time to desk work. There is no merit in sitting still 
just to learn to sit still, and so long as we work hard 
and fast, it does n't matter how much we wriggle. 
There is no known way of making sitting still 
healthy for children. The only thing is to reduce it 
to its lowest possible terms. 

Seats and desks that fit us. While we are sitting 
to read and write, we should select desks which are 
fitted to our height and size, so that our bodies can 
be comfortable while our minds are at work. The 
school seat should be placed at the height of our 
knees. When we sit down upon it, it should be low 



138 COMMUNITY HYGIENE 

enough so that the whole soles of both feet rest 
comfortably on the floor, and high enough so that 
it does not double up our knees and throw our bod- 
ies backward. The top of the desk or table should 
be of such height that when we sit comfortably and 
fairly upright in the seat, with the right arm bent, 
the elbow will rest comfortably upon it. The edge 
of the desk or table should be almost directly above 
the front of the seat or chair, although at some ages 
and for some kinds of work a slight overhang of an 
inch or an inch and a half is more comfortable. The 
best seat ever invented is a light, well-shaped chair, 
with a moderately sloping back curved to fit the 
natural curves of the body; and the best desk is a 
simple table, light enough to be easily moved about, 
but firm enough to be perfectly steady for writing. 
Chairs and tables take up a little more room than 
desks, but that is one of their advantages. Children 
should not be packed at two-foot intervals in rows 
of seats crowded together like sardines in a can. 
Tables and chairs will supply seats for all the chil- 
dren that the room is big enough to provide air for. 
These tables and chairs can be made in the school 
shops by the upper grades and repaired and re- 
placed as needed. Another great advantage of 
tables and chairs is that they can be promptly 
cleared away and stacked up around the walls of the 
rooms to leave space for drills, dances, and play. 

Crooked backs and round shoulders. We have 
often been told of the importance of keeping our 



THE DESKS AND BLACKBOARDS 139 

heads up, our shoulders back, and our backs straight. 
Nothing is more ungainly or worse for our chest de- 
velopment than rounded shoulders, humped backs, 
or slouching carriage. These bowed backs and 
rounded shoulders are in part due to careless ways 
of sitting or standing, but they are much more due 
to a lack of vigorous active exercise and proper 
amount of food. This lack of food may be due to a 
badly planned diet, but more often it comes from 
the poor appetite caused by. sleeping in ill-venti- 
lated rooms and failing to get a proper amount of 
play and exercise in the open air. 

We must remember that the human body is 
naturally built in curves, and that the constant pull 
of vigorous and well-nourished muscles is necessary 
in order to draw those curves into that compara- 
tively straight line which we call good carriage of the 
body. The moment our muscles become weak and 
our blood poor, we sag. Play hard, wholesomely, 
happily ; eat plenty of good wholesome food to meet 
the appetite that comes from such play; and you 
won't have much trouble with round shoulders or 
crooked backs, even if you should have to sit still 
longer than is desirable, or in seats and at desks 
which do not fit you. 

Our body tires before our mind does. Com- 
fortable seats and desks, plenty of change of posi- 
tion, drill, dancing, play, work at the bench or in the 
school garden, are important from the mental point 
of view as well as the physical one. The more care- 



140 COMMUNITY HYGIENE 

fully we study the reasons for getting tired in 
school or at office work, the more we find that it is 
the body, not the mind, which tires. If we keep our 
bodies rested by plenty of good air, change of posi- 
tion, comfortable seats and desks, frequent changes 
of occupation and chances for rest, our minds will 
keep on at work for a surprising length of time with- 
out marked fatigue. When we say, for instance, that 
our eyes are tired, it is not the optic nerve or nerve 
of sight which is tired, but the little muscles inside 
the eye which, by their contraction, shorten the 
focus of the eye and adjust it for near work like 
reading and writing. If we shut up our books and 
run outside and look up into the tops of the trees 
for apples, or follow the flight of a baseball, our eyes 
begin to feel rested, although we are still using them 
hard. 

Another form of tiredness that comes from read- 
ing too long is in the little muscles outside of the 
eyeball that move it from side to side. These be- 
come tired from constantly running along one line 
and back to the beginning of the next. Also it makes 
them tired to pull the eyes together so as to focus 
both of them on the page. 

Our tiredness after writing too long does not come 
from our eyes or even from the writing center in the 
brain, but from the cramping and weariness of the 
muscles of the hand and arm. If we watch carefully 
the different groups of muscles in our own body and 
as soon as they begin to get tired change our position 



THE DESKS AND BLACKBOARDS 141 

or the nature of our work so as to avoid cramping 
or overtiring in one small group, we shall be able to 
do a great deal more work in the course of the day 
and with less danger to our health and comfort. 

Blackboards and eye-strain and dust. The black- 
board is a valuable part of the school-room outfit, 
because it gives our eyes a change from the short- 
range, quickly tiring use of books and papers to 
long-range use of the sight across the width of the 
room. It gives us a certain amount of hand and arm 
exercise, as well as a change of position, and enables 
us to draw large pictures of the things that we have 
in our minds instead of describing them in the small, 
cramped scratches we call writing. 

Blackboards, however, have two great drawbacks. 
It is difficult to prevent some of them from being 
placed between windows, which makes our eyes 
dazzle when we try to read what is written on them. 
To correct this, the shades may be pulled down 
during blackboard exercises; or only one half to one 
third of the class may be sent to the blackboard at a 
time, so as to use only those portions of the black- 
board which are on the walls opposite the windows 
or at right angles to them. 

Another drawback is the dust made by the chalk 
and crayons. If this is not thoroughly cleaned off, 
the clear dead black or green of the board becomes 
a dull gray after a few months' use, and the mark of 
the crayon does not show clearly. That means eye- 
strain. If this dust is cleaned off too vigorously, and 



142 COMMUNITY HYGIENE 

the dusters are beaten out in the schoolroom, the air 
becomes filled with the clay or chalk dust, which 
irritates eyes, nose, and mouth, and soils clothing 
and books. These drawbacks may be corrected by 
having the blackboard thoroughly washed at fre- 
quent intervals. Erasers should be used only for 
making changes in the blackboard work during 
classes. At the end of the day, the board should be 
wiped with a cloth which can be shaken out of doors 
and frequently washed. The so-called dustless 
crayons are not very satisfactory, inasmuch as they 
are likely to contain talc and other semi-greasy sub- 
stances, which make the surface of the blackboard 
smudgy and slippery to the touch of the crayons. 

Why we stand up to recite. Our habit of standing 
up to recite is in part a survival of the dress-parade 
methods of the drill sergeant, and in part a simple 
way of giving us some slight change of posture and 
occupation. Putting our hands behind us and 
straightening our backs is also a good change of 
position after bending over the desks. In many 
schools change of position is afforded by calisthenics 
in the halls, or by marching around the room and 
singing. All of these are excellent for the health, 
providing that you don't stamp hard enough to 
raise unnecessary dust. 



CHAPTER XVIII 

FLOORS, HALLS, STAIRS, AND BASEMENTS 

Floors and dust. The question of the schoolroom 
floor has always been a troublesome one. No paint, 
polish, or other finish has ever been invented that 
will withstand the trampling of scores of restless feet. 
Carpets are equally out of the question. A bare 
floor wears out just as rapidly as a painted or pol- 
ished one, developing cracks, splinters, and a soft, 
spongy surface, which furnishes such a foothold for 
dust and dirt that it cannot be kept clean after a 
few months or years of wear. Consequently, it is 
very difficult, especially in old or crowded school 
buildings, to keep the schoolroom free from dust. 
As this dust consists of the mud of the streets and 
contains large quantities of dried manure, it is not 
a wholesome thing to have floating in the air we 
breathe. In many schoolrooms the filing out of the 
classes will raise a visible cloud of dust; and any 
attempt at marching or dancing will send almost as 
much dust as oxygen into the lungs of the children. 

The best modern school buildings have either 
hard-wood or narrow-board hard-pine floors. If 
these are well laid and kept constantly oiled, pol- 
ished, and cleaned, a good deal of the dust nuisance 
may be avoided. Vigorous scrubbing will keep the 



144 COMMUNITY HYGIENE 

nuisance down to a certain degree, but it shortens 
the life of the floor. Various forms of dressings with 
crude oil and other substances have been devised, 
but although these keep down the dust, they darken 
and blacken the floor, making it unattractive and 
often staining the hems of dresses. 

Various other substances than wood have been 
tried for schoolroom floors. In some cases we have 
gone back to the stone slabs or flags with which the 
ground floors in old buildings were sometimes laid., 
These, however, are cold and damp in winter. More- 
over, they may break anything which is dropped 
on them, from an ink-bottle to a child's head, and 
they are exceedingly noisy. Cement has the dis- 
advantage of being considerably more expensive to 
lay than wood, because it requires much heavier 
floor beams to carry it and prevent its cracking; 
also, it is somewhat noisy. But it has the great ad- 
vantage of wearing like iron and always keeping a 
smooth, hard, washable surface, which can be kept 
spotlessly clean with little effort. Also it can be 
rounded over the corners at the base of the walls, so 
as to leave an absolutely dirt- proof, dust-proof sur- 
face without joint or crack. It is of a pleasing color 
naturally, and can readily be tinted to any desired 
shade or be given a pattern. Experiments are now 
being made which promise to correct its hardness 
and noisiness by mixing it with oil or with combi- 
nations of paper pulp or wood pulp. Before long we 
may have a cement floor which will be waterproof, 



FLOORS, HALLS, STAIRS, BASEMENTS 145 

fireproof, dustproof, fairly elastic, pleasing in color, 
and permanent. 

An old and worn floor can be turned into a sani- 
tary one for several years by giving it two or three 
coats of paint, so as to fill all cracks and crannies, 
and then laying over it a cork carpet, linoleum, or 
thick oilcloth such as is used in hospitals. Frequent 
and regular washing, cleaning with a cloth or mop, 
and avoidance of the broom will reduce the floor- 
dust nuisance to a minimum on most floors. 

Halls that waste space. The question of the hall- 
ways in school buildings is also a difficult one. Their 
floors are subject to even severer wear and tear than 
those of the schoolroom. Hence they are difficult to 
keep clear of dust. For hall floors, cement is the best 
material, as its hardness and coldness are of little 
importance here, and its noisiness can be largely 
overcome by a strip of rubber or linoleum laid down 
its center. 

Waste of space in halls is also a serious defect. 
Their sole use is to provide a way into and out of the 
different rooms. On account of the square or block- 
shaped construction of some of our older buildings, 
as much as a fifth, or even a fourth, of the total 
floor space is wasted in hallways. This not only 
wastes space, but also causes difficulty in ventilation 
and lighting. Halls are usually near the center of 
the building, and consequently they are difficult to 
light properly and almost equally difficult to venti- 
late, except by making a chilly draft through them. 



146 COMMUNITY HYGIENE 

The modern type of school building tries to avoid 
the hall by building either in hollow squares around 
a central court, or in " T's " or " L's," or in the 
shape of the letter "E" surrounding three sides of 
the playground, with a central projection in the 
middle. In this way the buildings are nowhere more 
than one room and a corridor wide. By opening the 
windows in that corridor and the transoms over the 
doors, every room can get cross- ventilation straight 
through it, no matter what the direction of the wind. 

Another disadvantage of the old-fashioned large 
hall was its noisiness. Being high, bare, and empty, 
the sound of feet upon its floor echoed through the 
rooms. The passage of a single class through it from 
one recitation room to another would disturb the 
whole building. Also, since it usually ended in stairs 
going down into the basement, any smoke or gas or 
odors from the toilets, cloak-rooms, or lavatories 
swept up through it, as through a chimney, and 
filled the whole building. In some of the newest 
school buildings, the corridors which connect the 
classrooms are simply roofed colonnades or porches, 
so that a class goes out into the fresh air every time 
it changes from one room to another. 

Stairs that are easy to climb. Stairs in a school- 
house should be broad, with low treads and gradual 
risers, so as to be easy for the shortest legs to climb. 
They should be made of iron and cement, or iron and 
glass, or some other fireproof material, and to pre- 
vent slipping each step should be surfaced with a 



FLOORS, HALLS, STAIRS, BASEMENTS 147 

softish cement or with a rubber or cork mat. They 
should be well lighted, so that there shall not be 
the slightest danger of stumbling or missing the 
footing in dark corners or at badly lighted turns. 
They should be free from sharp turns or abrupt 
angles or square landings where two stairways 
meet. 

These last requirements are largely on account of 
the fact that in most school buildings the stairs are 
depended upon as fire escapes. If they are made 
properly, and careful fire drills are practiced, they 
will empty a building more rapidly than any fire 
can spread through it, unless it has a tremendous 
headway. School buildings should be built entirely 
fireproof; but until they are, it is of the utmost im- 
portance that the stairways should be broad and 
well lighted, easy-sloping and free from dangerous 
angles or pockets. It is of great importance that all 
doors opening out from the foot of stairs should be 
made to swing out or swing both ways, and so con- 
structed that the slightest pressure from the inside 
will unlatch or unlock them at once. 

Keep the basement above the ground. The best 
basement for any school building is none at all. 
In the days when large quantities of wood and coal 
had to be stored away for the whole winter, and 
when lumber- and junk-rooms were considered nec- 
essary, there was some possible excuse for that 
half-civilized cellar called a school basement. Now 
there is practically none. If you feel that you must 



COMMUNITY HYGIENE 




Courtesy Russell Sage Foundation 

THE SAFE KIND OF DOOR 

Children are never burned to death in a school 
equipped with this kind of door. One touch on 
the " panic bolt " and the door swings open of it- 
self to let the children out. 



have a basement, 
grade the ground 
around it so that 
it will be at least 
half above ground 
level. There is 
plenty of room for 
the furnace, heat- 
ing-plant, and a 
month's supply of 
coal in a fifth, or a 
fourth, of the space 
usually occupied 
by a school base- 
ment. The remain- 
der offers a play- 
ground for rats, 
mice, and cock- 
roaches, provides 
a place to keep 
things that should 
not be kept, and 
is likely to end 
in the installation 
of shops, lunch- 
rooms, and even 
class-rooms below 
grou n d level, 
where they should 
never be allowed. 



FLOORS, HALLS, STAIRS, BASEMENTS 149 




Courtesy Bureau of Welfare of School Children, Deft. Social Welfare, N. Y. Ann. 
for Improving Condition of Poor, and Dept. of 'Education, N.T. 

WHY BASEMENTS ARE DANGEROUS 

Oil-soaked brushes and brooms, rags and trash gather in them and furnish places 
for fires to start. This should not be allowed in a modern school. 

Keep basement light and clean. If there is a 
basement, it should be kept just as clean and well 
ventilated as any other part of the building. This 
is partly for the same reasons that house cellars 
should be kept clean, and partly because of the 
likelihood of waste paper, old textbooks, and trash 
gathering in it. Nearly half the serious fires in school 
buildings, factories, and office buildings are due to 
a pile of paper, rags, floor sweepings, or other in- 
flammable waste in some corner of the basement. 
A basement is the most dangerous place for a fire 
to start, for the same reason that we light a fire in a 
stove or grate by touching a match to the bottom 
of the pile of fuel instead of the top. 



CHAPTER XIX 

CLOAK-ROOMS AND CLOSETS 

Toilets should not be in basement. Unless the 
toilet can be placed in a part of a basement where 
it will have plenty of light, and where the sun may 
enter freely during a considerable portion of the day, 
it is almost impossible to have it kept properly 
clean ; and it is also difficult to ventilate. Although 
large toilets may be located in the basement, there 
should always be smaller toilets placed in outside 
or corner rooms, with good ventilation, on each 
floor of the building, for convenient use at all times 
except at recess and before and after school. Better 
still, the large toilets may be installed in a small 
one-story projection upon the ground floor. 

Plenty of light and air. It is a hard matter, even 
with the most scrupulous care, to keep washrooms 
and toilets entirely free from odor. In fact, the only 
way to avoid offensiveness is to practice spotless 
cleanliness and make provision for the rapid escape 
of such odors as may be present and for abundant 
ventilation of every part of the room. The floors 
should be of cement, while the walls should be of 
some waterproof and washable material, tiled or 
slate-coated up to the height of five or six feet in and 
around the toilets and closets. 



CLOAK-ROOMS AND CLOSETS 151 

Light and cleanliness the best cleansers. A great 
variety of deodorizers and so-called cleansers have 
been devised to keep toilets and washrooms in a 
sanitary condition. Not one of these is of the slight- 
est value as a substitute, first, for good construction ; 
second, for cleanliness; and third, for light and air. 
In fact, most of them had better be dispensed with 
altogether, except certain forms of oils and paraffins 
which can be used to waterproof and make easier the 
cleaning of certain soiled surfaces. Most of these 
so-called deodorizers and cleansers do little more 
than add another offensive and equally unwhole- 
some smell to those already present, and thus con- 
ceal these so that the necessary care is not taken to 
get rid of them by proper sanitary measures. 

Matron in the cloak-room. It must never be for- 
gotten that even the most perfect of sanitary appli- 
ances will not give good results unless the toilet- 
room is used in a cleanly, sanitary, intelligent 
manner, and constantly watched in order to prevent 
the beginning of any souring or putrefaction of soiled 
surfaces. It is best to have toilet- rooms patrolled 
at regular intervals throughout the day, either by 
the janitor or matron, to prevent uncleanliness and 
to detect offenders against good manners and cleanly, 
decent habits. 

In our crowded centers, the school washrooms, 
cloak-rooms, and toilets are educational factors. 
Habits and standards may be formed there which 
will be carried into the home and raise the general 



152 COMMUNITY HYGIENE 

living standards of the whole community. The aim 
of the schools should be to lead in these matters by 
establishing a standard of cleanliness, hygiene, and 
conduct which is just a little in advance of that of 
the community in which it stands. In the larger 
schools it is a very good plan to have a matron in 
attendance in the cloak-rooms, both on the girls' 
side and among the younger boys. 

Another feature which ought to be made a regular 
part of every schoolhouse, except the smallest and 
most simple, is a bath with hot and cold water. In 
crowded districts where many of the tenement 
homes have no proper bathrooms, these baths should 
be numerous enough to provide every child in the 
school with at least one and preferably two baths a 
week. These should be taken in school time. This is 
a regular institution in many of the best English 
and Continental schools. It is also an excellent 
means of enforcing standards of personal cleanliness. 
A boy or a girl inclined to be untidy or slovenly in 
personal habits will profit by the hint when sent 
down by the teacher to take a bath. During the 
lunch hour or after school those who cannot have 
a comfortable warm bath in their homes may be 
allowed to take one in the school, either free or on 
the payment of a small sum for towels and soap. 

Sterilizing-closet for clothing. All cloak-rooms 
should have at least one window opening to the 
outside, and preferably two or three. The habit 
of using a dark end of the hall or an airless dark 



CLOAK-ROOMS AND CLOSETS 153 

ante-room partitioned off from the schoolroom is 
bad. 

The cloak-room should be well lighted and well 
ventilated. In a furnace- or steam-heated building, 
it is well to have a stream of hot dry air driven 
rapidly through the clothing whenever the children 
have come to school in the rain. In crowded schools 
where some of the children come from crowded 
districts, it is a good thing to have a small sterilizing- 
closet, in which clothing which is suspected of being 
infected can be hung and sterilized by steam or 
formalin. 

Rest-rooms with cots. Every school, even the 
smallest in the country districts, should be provided 
with a rest-room large enough to contain a cot or 
lounge, upon which children who become tired or 
are suddenly taken ill can be made comfortable until 
they recover or can be taken home. It is also an 
excellent place to put the small children who go to 
sleep over their lessons in the middle of the morning. 
Some children have to walk a considerable distance 
to school and are so tired by the time the midday 
recess comes that they need a nap after they have 
eaten their lunches. Provision for this in the rest- 
room will improve the quality of their afternoon 
school work as well as protect their health. It should 
also be a standard of school conduct that whenever 
a child feels tired enough to want to go and lie down, 
he should be permitted to do so without having to 
give any reasons or letting his request become public. 



CHAPTER XX 

PLAYGROUNDS AND SHOPS 

The pleasantest part of the schoolhouse. The 

playground is the pleasantest and one of the best 
parts of the school plant because it is the healthiest. 
Nothing will ever repay us in after years for not 
having good health in childhood. We can learn all 
through our lives, but the ten years from five to 
fifteen are the time when we can grow to best 
advantage. 

The most progressive schools are beginning to 
make the playground a larger and larger part of the 
course of education. The city of Chicago, for in- 
stance, in recent years has insisted upon procuring 
at least five acres of ground for each new school site 
purchased. The school authorities in Gary, Indiana, 
began with two acres for their first school, then pro- 
vided five acres for their second, and fifteen acres 
for their third school; and every foot of ground is 
used in their scheme of education. 

The more we learn on the playground, the less 
time we need to spend in the schoolroom. A school 
building, with large, well-equipped playground and 
shops, can accommodate twice as many children as 
the old-fashioned schoolhouse of its size used to 
hold, because half of them are in the open air, or at 



PLAYGROUNDS AND SHOPS 155 

work in the shops, while the other half are in the 
classroom. 

What we learn at play. We recognize to-day that 
some of the most valuable lessons we learn in our 
lives are those learned on the playground. In the 
first place, the playground is the only place where we 
can learn to control our bodies ; to become swift and 
sure of foot ; clear and certain of eye ; strong in wind 
and limb ; able to catch and to throw and to balance, 
to take care of ourselves and to protect others. A 
quick eye, a steady hand, good judgment, and grit 
are far more important to success in life than gram- 
mar or algebra or Latin. 

On the playground we learn to work with others ; 
to take our place in the team; to put the success of 
the group above our own vanity or pride ; to control 
our tempers; to bear pain and fatigue and hard 
knocks without wincing; and to play fair. We are 
taught a great many things about conduct and 
goodness by word of mouth or out of books, but the 
code of morals that we are likely to live by is the one 
we learn on the playground. 

How play helps study. If you have an hour in 
which to get a lesson, the most economical way to 
do it is to spend a part of that hour in play, unless 
you are very tired, when sleep is better. It matters 
little whether play comes in the first part or the 
second part of the hour. If you take the play first, 
it will rest your eyes and tune up your muscles until 
the work will seem like play to you. If you do your 



156 COMMUNITY HYGIENE 

work first and take your play as a reward, you will 
be so eager to get out to play that you will work 
hard and finish the task before you know it. It is 
the opinion of scientists, teachers, and doctors that 
if children ■ — and grown-ups as well — spent in play 
or sleep about half the time now spent in work, more 
and better work would be done with less injury to 
health. 

It is astonishing how fast your brain will work 
when you are well fed, well exercised, and well 
rested. The aim of education now is to alternate 
work and play, exercise and rest, so that all our 
important work will be done when we are in the best 
possible condition to do it. 

What fatigue means. Fatigue, or tiredness, is not 
just laziness, but a poisoned condition in which our 
nerves and our muscles, our brains and our lungs 
are full of the waste products of our own activities. 
The only way to get rid of these poisonous waste 
products is to lie down and sleep, or to change our 
occupation, preferably for play or pleasant work in 
the open air. If we keep on driving ourselves in 
spite of this poisoned feeling, we shall get little more 
work done. What little we do will be of poor quality, 
and what we try to learn when in this condition, we 
shall soon forget. In every kind of work our aim is 
to stop just short of actual fatigue. The more impor- 
tant the work is, the more necessary is this rule. 
By changing to some occupation in the open air, our 
lungs have a chance to burn up these poisons. In 



PLAYGROUNDS AND SHOPS 157 

half an hour or an hour we can come back fresh and 
go at our work again with redoubled energy. 

Another advantage of alternating study with play 
and with work in shops is that we learn not merely 
with our eyes, ears, and memories, but also with our 
hands, feet, muscles, and sense of touch. We are 
taking in information from all five of our senses in- 
stead of from only two or three of them, as when we 
work at a desk in school. 

Play-places in wet weather. The Greeks had the 
finest schools the world has ever seen. They were all 
playgrounds and open porches. Half their world- 
famous lectures, debates, and dialogues were given 
in the open air. They had the advantage of the 
beautiful Mediterranean weather, with bright sunny 
days practically ten months of the year. In our 
harsher, stormier climates, we have to make pro- 
vision for rain and snow; and it is therefore most 
important that every school playground should have 
one or more large covered play-sheds. These should 
be without walls, or have a wall on only one side. 
Movable shutters, window sash, or curtains can be 
drawn on the side toward the wind to keep out the 
rain or snow. With such a shed, active, lively play 
can be carried on in the open air practically twenty- 
nine days out of every month in the year. 

If the open ground on which we play is dry and 
well-drained, a little moisture or snow in the air 
won't hurt us a bit. It is most important that the 
surface of the playground should be covered with 



158 COMMUNITY HYGIENE 

small gravel, finely screened ashes, clean, sharp 
sand, or other porous material, and carefully 
graded, so as to shed the wet all over its surface. 
It should be well drained at its edges and by tiles 
two or three feet below the surface. Then there will 
be no danger of puddles forming or mud being 
trodden up even in the wettest weather. 

The swimming-pool. A swimming-pool ought to 
be a standard part of the equipment of every school 
which can afford it. Swimming is not only one of 
the best exercises, but it is a great help toward 
keeping our bodies clean and vigorous, and a practi- 
cal accomplishment of great value, as it may enable 
us to save our own life or that of another. The 
actual number of people drowned, except among 
fishermen and sailors, is comparatively small, but 
we never know when we may be in that danger. 
Now that travel is becoming so much more frequent, 
it is a satisfaction to feel that we can take care of 
ourselves in the event of an accident on shipboard 
or on the pier. One of the greatest values in know- 
ing how to swim is that it enables us to keep our 
heads in time of danger, because we have this re- 
source. It should be a part of every child's educa- 
tion; and in every town with a public system of 
water-supply, it is a simple matter to make a 
swimming-pool. The only important expense is 
digging and lining the pool with cement, and this is 
by no means excessive. 



CHAPTER XXI 

THE SCHOOL DOCTOR AND THE SCHOOL NURSE 

Keeping fit for work. An engine may have a fire 
under its boiler, a good head of steam, and its fly- 
wheel, shafts, and gears in perfect condition; yet, if 
a little grit finds its way into one of the bearings, the 
whole thing breaks down. In the human machine, 
one of the most important things to guard against is 
getting dirt into its bearings. The most dangerous 
form of that dirt is germs. The workers of a nation 
lose a great deal of time through unemployment by 
the failure of crops, the burning of factories, panics 
and failures in business, but by far the greatest loss 
of time in human working power is that caused by 
disease. On an average we lose about fifteen or 
twenty days every year by sickness. It is well worth 
our while, therefore, to give intelligent attention to 
the best ways of avoiding those tiny dirts which get 
into our bodies and make trouble. 

The stitch in time. We have all heard of the 
stitch in time that saves nine by holding the gaping 
edges of the little tear together and keeping it from 
spreading. That is exactly what we should try to 
do with the infectious diseases. Fortunately, most 
of them are comparatively mild, and if taken in 
time can be so handled as to be almost harmless to 



160 COMMUNITY HYGIENE 

ourselves and to others. But if we neglect even the 
mildest of them, such as an ordinary cold in the 
head or a sore throat, it may develop into serious 
trouble which may leave scars upon our hearts or 
kidneys or lungs and injure us for life. 

Saving ourselves and protecting others. If we 
know early that we have one of the mild infectious 
diseases, as measles or chicken-pox or tonsillitis, or 
even a common cold, we should stay in our room and 
avoid infecting others. It is quite as important to 
keep from spreading disease as it is to save ourselves 
from a serious attack. Fortunately, the rest in bed 
which will help nature to cure us most quickly is 
also the method which best prevents us from in- 
fecting anybody else. 

The school clinic. It has now become customary 
in most of the larger city and country schools, where 
many children are brought together, to have a school 
doctor or school nurse, or both. They come in fre- 
quently and look over the children quickly, to see 
whether any of them show signs of being sick or out 
of sorts. When children are found with flushed faces 
or headaches or coughs or sniffles, they are either 
sent to the rest-room to be made comfortable or sent 
home and advised to call the family doctor. Often 
the nurse will go home with the children to see 
whether any other members of the family are sick 
and make arrangements to have them taken care of 
promptly. If the trouble is due to a cut finger or a 
bruised head or a chronic sore throat or some form 



THE SCHOOL DOCTOR AND NURSE 161 

of skin disease, the pupil is taken to a room in the 
building provided for the purpose, where the nurse 
dresses, bandages, paints with iodine, rubs on salve, 
or does whatever may be necessary. 

Vacation schools in the country. Some city schools 
now buy a small farm in a pretty, healthful part of 
the country five or ten miles out of town, and build 
there open-air schoolrooms with sleeping-porches, 
dormitories, sheds, shops, and big barns. School 
children who are out of health or are not growing 
properly, or who can't find a place to play in the 
crowded city, are sent there for two weeks or a 
month or three months. Often children who are not 
making proper progress with their studies or in their 
growth, because their blood is poor or their hearts 
are weak or their digestions are out of order, will 
come back from a stay in this open-air school rosy, 
strong, hearty, and ready to make up two grades in 
a year. These school farms are also used in the 
summer time as vacation camps for all the children. 
Squads of ten to fifty at a time race across the fields, 
climb the trees, swim in the creek, and roll on the 
grass. They learn about birds, flowers, animals, 
farm work, food-supplies, and life in general, even 
if they do not do much book work. 

Eyes and ears. The two parts of our machinery 
which are most likely to break down in the school- 
room are our eyes and our ears, because they are in 
such steady use. Partly for that reason, the begin- 
ning of sickness shows itself in them very quickly. 



1 62 COMMUNITY HYGIENE 

As soon as the germs have swarmed in millions all 
through our blood, so that we begin to be feverish, 
our eyes begin to feel hot and tired, and to look red 
and swollen. When your eyes begin to smart and 
water and it is an effort to see the letters on the 
page, it is a good time to take a rest, If that does n't 
make them feel better, go to the school doctor and 
tell him that you don't feel well and let him find out 
what is the matter. If your ears begin to buzz and 
feel stopped up and uncomfortable, you are prob- 
ably getting a cold in the head or throat which is 
spreading to your ears, or you are beginning to have 
a fever. Again, it should be a sign to stop work and 
go to the doctor or nurse, or to your mother, if you 
are at home, for treatment and care. 

One of the important things to consider in a 
schoolroom is its hearing properties, or acoustics, as 
the scientists call them. Words spoken by the 
teacher or the class in an ordinary tone of voice, such 
as is used in recitation, should be heard everywhere 
in the classroom. If any pupil finds it difficult to 
hear the teacher from his seat, he should report it 
at once, so that if others find the same difficulty the 
teacher may make the necessary changes in doors 
or windows, or have a screen hung from the ceiling 
to make herself heard in every part of the room. 

If, on the other hand, no one else has difficulty 
in hearing the teacher, there probably is something 
wrong with the hearing of the pupil who fails to 
understand what she says, and the school doctor or 




f Holographs by Mary H. Northend 

THE SUMMER CAMP AND VACATION SCHOOL 

It is just as important to learn to swim and ride and play wholesome out-of-door 
games as it is to learn things in books. Summer camps and vacation schools teach 
boys and girls how to grow up into strong, healthy men and women. 



164 COMMUNITY HYGIENE 

school nurse should be called in to see what can be 
done to improve the hearing. This is very import- 
ant. In childhood nine cases of deafness out of ten 
can be almost completely cured by proper treat- 
ment. In fact, it has been found that many children 
who were supposed to be stupid or careless or in- 
attentive were merely unable to hear what the 
teacher was saying ; and as soon as their hearing was 
improved they quickly became good students. 

The commonest cause of deafness in children is 
some form of chronic catarrh in the nose and throat, 
and particularly a spongy swelling and inflamma- 
tion of a little gland like a tonsil, which lies just at 
the back of the nose and in the roof of the back of 
the throat. This little spongy, glandular body may 
become swollen and enlarged until it is as big as a 
large blackberry. It then blocks up the back of the 
nose, making it hard to breathe through the nostrils 
and may press upon the little tubes which run from 
the back of the throat to the drum cavity of the ear 
to supply the drum with air, and set up inflamma- 
tion there. When these little tubes become blocked 
up and swollen, the drum of the ear becomes thick- 
ened and inflamed, and the little patient becomes 
hard of hearing or quite deaf. These spongy growths 
are known as adenoids. Fortunately, a slight and 
almost painless operation will remove these ade- 
noids, completely curing the obstruction of the nose 
and the deafness at the same time. You can recog- 
nize children who suffer with adenoids by the ex- 



THE SCHOOL DOCTOR AND NURSE 165 

pression of their faces. Since the nose is blocked up, 
they have to open their mouths in order to get 
enough breath and so become what we call ' ' mouth- 
breathers." Going about with their mouths open all 
the time gives their faces a vacant, stupid expression. 
Since their nostrils are not used properly to breathe 
with, they do not grow as they should, the sides of 
the nose sink in, and the nose looks pinched and 
blocked up. 

Noses and throats. The commonest place for 
trouble to show itself first is in our noses and throats. 
Many of the germs which cause disease are breathed 
in and lodge first on the sticky ventilation coils in 
our noses or in the hollows about our tonsils and in 
the back of our throats. Cold in the head, sore 
throat, measles, scarlatina, and whooping-cough 
often begin with a slight headache, closely fol- 
lowed by a feeling of swelling and stickiness and 
soreness in the throat or of stuffiness and tickling in 
the nose. Nine times out of ten when you have these 
uncomfortable feelings, it means that you have 
caught some mild infection, and you should go 
home at once and keep yourself comfortable, well 
ventilated, and at rest until you are well. You will 
gain nothing by trying to work in this condition, 
because you can't fix your attention properly on 
the lesson. While it is not a pleasant thing to be 
sick, even in the mildest way, there is nothing to be 
uneasy about if your head begins to ache and your 
throat feels a little stiff. Almost everybody has one 



166 COMMUNITY HYGIENE 

or more little attacks of this sort every winter. 
Ninety-nine out of a hundred of them will quickly 
get better of themselves within three or four days if 
you go home and keep perfectly quiet and rest in 
good, pure air. 

Rashes and pimples. In sickness where there is 
fever, the body is hotter than it should be. The face 
becomes somewhat flushed, because the heart .is 
pumping the blood out to the surface of the skin to 
cool it off as quickly as possible. In some of the 
milder diseases, like measles or chicken-pox, this 
redness of the skin goes deeper, and little blotches 
or mottlings or spots of various kinds appear upon it. 
These are known as a rash or an eruption. Such a 
rash is practically always the sign of some form of 
infectious disease, and it is well to keep away from 
any one who shows signs of it. If a rash is not 
caused by sickness or fever, it is likely to be some 
local skin disease. Many of these are infectious, and 
all of them are disagreeable. If you were old enough 
to nurse and take care of your playmates, it would 
not be right to keep away from them when they look 
or are sick. But until you are grown up, you can do 
them no good, and may do yourself a great deal of 
harm by talking or playing or sitting with them, 
besides possibly carrying their infection to others. 

There is no need to be anxious about the possi- 
bility of catching these diseases, but they should be 
avoided as far as possible. If you will use your 
eyes and keep away from children who have flushed 



■■'■'% 








Courtesy Russell Sage Foundation 

SCHOOL NURSE AND DOCTOR AT WORK 



1 68 COMMUNITY HYGIENE 

faces and heavy eyes, or a cough or the sniffles or a 
rash or eruption of any kind, you will avoid many of 
the infections called " children's diseases." These 
diseases are almost always spread by children; and 
it needs only a little watchfulness and intelligence on 
your part to avoid most of this risk. 

How diseases spread. You will not catch these 
diseases in the street by passing children suffering 
with them. You are not likely to catch them even if 
you sit at some little distance from the sick children 
in the same room. Usually it is necessary to touch 
them or their clothing or their pencils or their 
candy or something which they have had in their 
hands or mouth before you will catch the disease. 
For this reason it is best not to exchange books with 
other children, especially if they look or have been 
sick. In many schools and in most libraries all books 
are disinfected by fumigating with formalin or sul- 
phur gas every month or so. The habit of moisten- 
ing the finger in the mouth in order to turn over the 
pages of a book should be avoided, especially if the 
book is old and the pages dirty. You should never 
on any account borrow pencils in school or lend 
yours. Many children have the habit of chewing 
the blunt end of their pencils, or putting the point 
in their mouths to make it write darker, or from nerv- 
ousness. If they happen to have in their mouths 
the germs of a cold or a sore throat or measles, these 
are left on the end of the pencil, and will be licked 
off by the next youngster who goes through the 



THE SCHOOL DOCTOR AND NURSE 169 

same foolish performance. You should always avoid 
putting the end of a pencil in your mouth. The 
best practical way to do this is to use a very soft 
pencil — No. 1 or No. 2 ■ — -so that you will not be 
under any temptation to wet it in order to make it 
mark black enough. 

Towels are also a source of dirt and of danger, 
because in wiping the face and hands you are almost 
certain to get a little of the moisture from your lips 
or nose on them. The roller towel should never be 
used. Every child should either be provided with 
his own towel to be kept in his desk, or there should 
be large piles of small hand towels like those used in 
hotels and Pullman cars, so that each child can have 
a clean one each time the hands are washed. If this is 
considered too expensive, a roll of paper towels may 
be hung up, from which a fresh sheet can be torn 
each time. Paper towels are not as pleasant to the 
face as cotton or linen, but they are just as good for 
the hands, and have the great advantage of being 
perfectly clean, safe, and inexpensive. 



SECTION IV— HOW THE COMMUNITY 
HELPS US 

CHAPTER XXII 

PURE-FOOD LAWS AND FOOD INSPECTION 

All foods pure as they grow. In the days of our 
grandfathers, when almost everybody either lived 
on a farm or in small towns or villages, there was not 
much need for laws about pure food or for food in- 
spection. Most people had room for a vegetable 
garden, a barn, and a chicken-house, and they 
raised their own vegetables and fruit, and produced 
their own milk, eggs, and butter. Most of the vege- 
tables were brought directly from the garden into 
the house for immediate use or for storage. The eggs 
were used as fast as the hens laid them, and the 
milk was brought into the pantry still warm and 
foaming in the pail. Even though dirt and dust and 
germs might be in the milk or on the vegetables, the 
bacteria did not have time enough to grow and cause 
much decay before the food was eaten. 

What causes food to spoil. As we have already 
seen, the principal things which cause foods to spoil 
and become unwholesome are germs — bacteria 
and molds. These germs grow at an extraordi- 
narily rapid rate, especially when they have both 



PURE-FOOD LAWS 171 

moisture and warmth. A few hundred bacteria in a 
pan of milk will increase to several hundred thousand 
within twenty-four hours, and to several millions 
within forty-eight hours. 

Although we should have all our food as nearly 
clean as possible, yet we have become used to small 
amounts of dirt and germs in our food and can 
manage to digest them without serious trouble. 
Unless the germs have had from one to four days to 
grow, or have been thrown into the food in large 
amounts, they cannot raise an army big enough to 
attack our stomachs and do us serious damage. 

Keeping foods clean in wagons and trains. At the 
present time nearly half of the people in the United 
States live in cities of more than eight thousand 
population, which means that less than a third of us 
are able to produce our own vegetables and fruit and 
milk and eggs. Consequently, most of our foods have 
to be shipped long distances by rail before they come 
into our markets, and then often make two or three 
shorter trips from the commission merchant to the 
wholesale dealer, and from him to the retail store, 
before they reach our kitchens and tables. In addi- 
tion to this, since railroads have been built and 
transportation is fast and cheap, we bring fruits and 
vegetables thousands of miles, from warmer climates 
in our own country in the early spring, and from hot 
countries in the winter time. Unless these foods are 
carefully handled and protected, they may gather 
dirt and infection during the days or weeks spent in 



172 COMMUNITY HYGIENE 

transit. Therefore it is necessary to have laws pro- 
viding that every care be taken to keep them clean 
during their journey, and that inspectors be paid to 
go backward and forward from the docks to the rail- 
road stations, the trains and the steamships, the mar- 
kets and the shops, to see that these laws are obeyed. 

Fortunately, most dirt or careless handling which 
makes food unwholesome to eat also makes it dis- 
agreeable to look at, and hence difficult to sell for a 
good price. Naturally those who ship and handle 
food are usually anxious to keep it as clean, cool, 
and free from dirt and germs as possible. Most of 
the railroads and big food-shipping firms have 
special cars built, which are not only absolutely clean 
and dust-tight, but are often provided with special 
systems of ventilation to keep the food cool and 
fresh. For shipments of fruits, vegetables, and fresh 
meats, they are provided with ice and fitted up as 
refrigerators. Foods can be carried to-day a thou- 
sand miles with less soiling and spoiling than they 
used to receive in ten miles of joggling in a peddler's 
dirty cart, exposed to dirt, dust, and sun. 

Keeping food clean in storage. Another difficulty 
is that food is shipped into the big railroad centers 
from such long distances and in such great quantities 
that often far more piles up there than people can 
eat at once. This surplus food used to be held until 
it was just beginning to spoil and there was no 
chance of selling it direct to the consumer. Then 
it was sold at a low price to peddlers and pretended 




THE MEAT INSPECTOR 

Condemning spoiled meat in a market, and putting a chemical on it which will 
prevent any dishonest butcher from selling it to any one. 



174 COMMUNITY HYGIENE 

farmers or market gardeners, who hawked it around 
in their wagons. This was a great waste, both for 
the farmers who grew it and for the housewives who 
bought the decaying stuff because it was cheap. In 
recent years food shippers have erected huge cold- 
storage warehouses, fitted up with racks and com- 
partments in which vegetables, meat, eggs, butter, 
etc., can be stored, and where the air is chilled be- 
low freezing-point to prevent germ growth and 
keep the foods from spoiling. 

In these cold-storage warehouses vegetables, 
fruits, and meat may be kept without spoiling, not 
only for weeks, but even for months and years. 
Indeed, the food dealers were so delighted with the 
way they could keep foods in these great ice palaces 
that they began to crowd in everything which they 
could not sell at a good price, and hold it until prices 
went up again. But it was found that, although 
foods could be kept in cold storage for a very long 
period without actually decaying, when they had 
been kept several weeks or months they had a dis- 
agreeable flavor or a flat, pasty appearance after 
they were thawed out. Dealers and health inspect- 
ors alike are agreed that it is bad to keep foods in 
cold storage for more than a moderate length of 
time. Moreover, if foods are already beginning to 
spoil when they are put in cold storage, the cold 
cannot cure the decay which has already taken 
place and the spoiling slowly continues until they 
become unfit for human food. 



PURE-FOOD LAWS 175 

Food which is to go into cold storage should be 
carefully inspected by the health officers or food 
inspectors, and any which shows signs of spoiling 
should be condemned at once. On the whole, cold 
storage, if honestly and cleanly conducted, is a great 
benefit to both the community and the food dealers, 
enabling foods to be kept fresh and sweet, and aleo 
to be stored away when they are abundant and 
cheap and kept for seasons of scarcity. 

Of course, no food should ever be stored except in 
compartments which are not only strictly clean, but 
well lighted, well drained, and well ventilated. If 
cellars are used, they should be provided with 
windows all around the top for good ventilation. If 
the light from the windows is not sufficient, the 
cellars should be equipped with electric lights. They 
should also be well drained and furnished with 
stoves, furnaces, or other means of thoroughly dry- 
ing the air at regular intervals between the periods 
when they are used for storage. This is necessary to 
kill molds and germs. Since the invention of the 
cold-air chamber, there is little excuse for permitting 
foods to be stored in cellars. 

Inspecting foods in markets. After food has been 
grown, gathered, packed in a cleanly, careful manner 
in clean crates and boxes, and shipped in a well- 
cleaned and ventilated car, — better still, a refriger- 
ator car, — it usually goes to some commission 
house or market. Here it is opened and exposed for 
sale to the grocers. Usually this is the opportunity 



176 COMMUNITY HYGIENE 

for a thorough examination by the food inspectors 
of the health department. Any food which is in bad 
condition or decayed is condemned as unfit for 
human food. The sound food is passed and fre- 
quently marked with a tag or label or stamp, show- 
ing that it has been examined and found to be pure. 
Usually the date of the examination is added. The 
food which is condemned is loaded at once into 
carts by city employees and carried to the city 
garbage crematory or dump. In some cases kero- 
sene is poured over the condemned products so that 
they cannot be sold as food, and the owners are 
ordered to dispose of them by burial or otherwise. 

This seems like a harsh procedure, but it has been 
found that if it is not insisted upon, the condemned 
food will be slipped out by a back door and sold to 
some dealer to be canned, peddled in the poorer 
parts of the city, or used by cheap restaurants for 
stews and hashes. No butter or eggs can be in such 
vile condition that they will not be eagerly bought 
and used by some baker or other person. The 
famous label devised by a practical joker to be hung 
on the egg-basket at the grocery store, "Rotten 
eggs, good enough for custard," was not by any 
means a mere flight of imagination. In fact, one of 
the bitterest fights which boards of health have had 
with food dealers all over the country is to deter- 
mine just exactly how rotten eggs may be allowed 
to be for legal use in the making of different grades 
of cake, custard, and confectionery ! 



PURE-FOOD LAWS 177 

Every imaginable trick is practiced to evade this 
inspection of food at the wharves, freight stations, 
and markets. It seems to be a point of pride with 
food dealers to sell every scrap of food which has 
spoiled on their hands — for some price — ■ to some- 
body — regardless of the consumer's stomach. That 
much-abused dish called hash makes the use of these 
food remnants easy; for onions will kill almost any 
odor except their own. 

Keeping food clean in shops. After food has 
passed inspection at the markets, it is bought by 
the retail dealers and delivered to the butcher shops 
and grocery shops. Here it meets a new source of 
danger from dirt and dust, because it is considered 
necessary to display it in as lavish and attractive a 
manner as possible, in order to catch the eye of cus- 
tomers. The food is exposed to flies and to the dust 
and germs that may be in the air of the shop, that 
may be brought in on the feet of customers, or 
coughed or sneezed into the air by them. Moreover, 
the store cat rummages the garbage-cans and prowls 
the roofs all night, and wanders about among the cu- 
cumbers or sleeps in the barrel of dried beans all day. 

This display of food is dangerous enough when 
vegetables are shown in the shops, but when they 
are arranged in banks out on the sidewalk against a 
wall or window, and even in tubs on the curb itself, 
it becomes most unwholesome and insanitary. All 
the dust of the street, the things which are shaken 
or blown from passing wagons, and the hairs from 



178 COMMUNITY HYGIENE 

stray dogs are sifted into and through the food, 
while the smoke and soot settles on it undisturbed. 
This risk is being abated, partly by the insistence 
of health officers and food inspectors, partly by the 
pressure brought to bear by committees of women's 
clubs and other public-spirited organizations, and 
partly by the shopkeepers themselves. All kinds of 
dry food, such as crackers, cookies, sugar, beans, 
peas, and macaroni, which used to be exposed in 
barrels, are now put up in neat packages protected 
from the dust. Pickles, preserves, and salt meats, 
instead of standing about in open kegs, are put up 
in attractive glasses or tins. Fruit baskets and 
boxes are fitted with inexpensive celluloid or glass- 
or paper covers. Vegetables and fruits in bulk are 
displayed in spotless glass cases with swinging or 
sliding sashes. Sidewalk displays are forbidden or 
limited to certain comparatively dust-proof prod- 
ucts, such as potatoes, turnips, and carrots, which 
are peeled or washed and boiled thoroughly before 
being used. These glass cases, celluloid covers, wire 
screens, etc., cost a little money and some trouble 
in the beginning, but they pay for themselves in the 
long run, because the goods keep so much better 
behind them. 

Inspecting bakeries, restaurants, and hotels. 
When the law has protected the food in its public 
course from the farm through the shop into private 
kitchens and pantries, it follows no farther. Each 
household is supposed to have a right to poison 




_ 



180 COMMUNITY HYGIENE 

itself if it so pleases, and is willing to suffer the 
consequences. It is assumed that our own self- 
interest will make us handle, cook, and serve our 
food in a cleanly, sanitary manner. This is usually 
true; but unfortunately there are some exceptions, 
and a thorough inspection by some competent sani- 
tary authority of private kitchens, pantries, ice- 
boxes, and cellars about twice a year would greatly 
benefit public health. The time has not yet come 
when we will permit inspection of our homes by 
experts, and so boards of health confine their atten- 
tion to hotels, bakeries, markets, and restaurants. 
There is a wide field of usefulness here. Most in- 
dividuals conducting such establishments wish to 
provide clean food at fair prices. But there are 
many ancient trade customs which are anything 
but sanitary. As individuals, the baker or hotel- 
keeper would be ashamed to practice them; but in 
the trade everybody does it. Curiously enough, all 
these trade customs are in the interests of the dealer, 
and against those of the community. For example, 
it is one of the traditions of the bakery trade that a 
bakeshop should be in a cellar. This custom began 
probably in a desire to get a cheap rent and to econo- 
mize fuel by preventing loss of heat during the hours 
when the oven must be kept at high baking tempera- 
ture. A cellar is always dark, usually ill-ventilated, 
often damp, and certain sooner or later to become 
dirty and insanitary. For this reason most cities 
with modern health departments have found it nee- 



PURE-FOOD LAWS 181 

essary to pass laws forbidding the use of cellars or 
other underground chambers for bakeshops. 

Another matter which must be carefully watched 
is the use of unwholesome eggs, butter, and milk 
by bakers, and of decayed meats, vegetables, and 
fruits by the keepers of hotels and restaurants. 

Hotel and restaurant kitchens are often placed in 
cellars or basements. In addition to the same in- 
sanitary conditions of lack of light and bad drain- 
age which make cellars so undesirable for bakeries, 
it is almost impossible to cool and ventilate these 
rooms properly, so that the large force of cooks, 
scullery-men, dishwashers, waiters, and other em- 
ployees are obliged to work under unhealthful con- 
ditions. These conditions make them particularly 
liable to catarrhs and consumption, and the germs 
which they cough or sneeze into the air are likely to 
be mixed with the patrons' food. The heat often 
keeps the workers in a drip of perspiration, and that 
perspiration is likely to drop into the food. The 
proper place for a hotel kitchen and dining-room is 
in the top story instead of the basement. This in- 
sures good light, air, and ventilation, and prevents 
the smells of cooking from rising through the rest of 
the house. 

Bad things added to foods. Another health danger 
which food inspectors must watch is the addition 
of various substances to foods to make them keep, 
to improve their appearance, or to increase their 
bulk. These added substances are usually either 



182 COMMUNITY HYGIENE 

hard to digest or actually poisonous to the stomach. 
They are called adulterations, and are sometimes a 
source of serious danger to health. 

Some of them, although frauds, are comparatively 
harmless. For example, some canning companies 
substitute apple juice or tomato pulp for straw- 
berries, raspberries, currants, and the more expen- 
sive fruits, in jams and jellies. Red pepper is sub- 
stituted for ginger in ginger ales. A dried root called 
chicory, or browned corn, or beans, or peas, is some- 
times ground in with coffee. 

Other adulterations are very dangerous to health, 
such as the use of copper to give a bright green color 
to canned peas, or of red aniline dyes to make catfish 
look like canned salmon, or the mixing of bad gela- 
tine with fruit juices to make jelly. The most dan- 
gerous adulterations are strong chemicals called 
preservatives, which kill the odor and cover up the 
appearance of spoiled or decaying meats in the 
preparation of canned or bottled goods, or in dried 
meats. The amount of adulteration ranges all the 
way from mere traces o'f the substance up to such 
works of art as the production of egg powders with- 
out a scrap of egg in them, or sausages made of 
bread, corn-meal, and floor scrapings from the 
slaughter-house, or potted chicken made of diseased 
veal. 



CHAPTER XXIII 

PURE WATER AND ITS SUPPLY 

Clean water comes down from the clouds. Like 
food, all water is clean and pure " where it begins." 
When it comes down from the clouds in the shape of 
rain, it is almost entirely free from germs. Most of 
the things that happen to it after it touches the 
ground do little to make it impure until it comes in 
touch with man or some of his works. 

As we have already seen, we are to blame for 
most of the contamination of our drinking-water. 
Most of the rain that falls on the surface soaks a 
little way into the soil, gradually drains down the 
slopes into the brooks and creeks, through these 
into the rivers, through the rivers into the lakes, 
or into the sea. If we want to drink it, we collect 
it at some one of these points in its course to the sea. 

What happens to the rain before we drink it. 
In early times camps, forts, and villages were built 
on the banks of streams so as to have a supply 
of water. Many farmhouses were placed near a 
brook or spring. Later, as the country grew more 
thickly settled, every house could not have a brook 
or spring of its own, and we began to dig holes in the 
ground, called wells, to catch rainwater as it soaked 
down through the surface soil. 



1 84 COMMUNITY HYGIENE 

These shallow or surface wells were dug near the 
house and the barn for convenience in supplying 
the kitchen and the stock. Consequently, dirt was 
washed into them from the back yard, the barn- 
yard, and the privy vaults, and the water became 
unfit to drink. Farmhouses may arrange and grade 
the land about their wells so as to avoid this dan- 
ger, but as soon as houses began to be built side 
by side along streets, with only a narrow alley 
separating them from another row facing on the 
next street, it was almost impossible to place a well 
so that no form of dirt or refuse could be washed 
into it. In all the downtown districts of cities the 
use of well water for drinking purposes is absolutely 
forbidden, though it may be used for manufacturing 
purposes other than washing or the preparation of 
food. 

Artesian wells and reservoirs. To take the place 
of these wells, the city is obliged to catch the water 
at another stage of its course toward the sea, — that 
is, in some stream, river, or lake, — bring it through 
a pipe-line into the city, and carry it in branch 
pipes down each street. Sometimes a good supply 
may be secured by boring deep wells down through 
the earth and rocks until some underground sheet 
or stream of water is struck. This has usually fil- 
tered through the soil for long distances, and is pure. 
It can be pumped into a reservoir and held for dis- 
tribution through the city. In some cases this water 
has run down into this underground hollow from 



PURE WATER AND ITS SUPPLY 185 

hills or mountains many miles away, and is under 
such pressure that, when the boring drill taps it, it 
will rise up through the shaft to the surface, or even 
spout up ten or fifteen feet into the air. Such wells 
are known as artesian wells, because they were first 
discovered in the province of Artois, in France. 

More commonly, however, the water of some 
river or lake is pumped into the city pipes. If the 
river or lake be large enough, a chamber or box 
with porous walls or openings covered by gratings 
to keep out mud and weeds is built on the bottom 
of the river or lake, out where the water is deep. 
The intake pipe starts from the bottom of this 
chamber, and the water is pumped through it into 
a reservoir or filter tanks, or directly into the water- 
pipes or mains. This chamber at the bottom of the 
lake or river is called a crib, or water-crib. 

If the stream or lake is not large enough to afford 
plenty of water through the entire year, a dam is 
built across it to form a reservoir. For the sake of 
water and boat traffic, most of our large cities were 
built on the bank of a river. In earlier days the 
water-supply was taken from these rivers, but as 
the country has become thickly settled, many 
houses, factories, small towns and villages have been 
built along their banks, and the waste draining into 
the rivers has made them too polluted for use as a 
direct water-supply. Consequently, it has become 
customary for our larger cities to secure their water- 
supply from some lake or river a considerable 



186 COMMUNITY HYGIENE 

distance away in the hills or mountains. If there is 
no large lake or river within reach, the city builds a 
huge dam across the whole valley of some mountain 
stream. This turns the region into a lake. Living 
or camping on the slopes which drain into the lake 
is forbidden, so as to keep the water perfectly pure. 
The city of New York, for instance, built, not long 
ago, a huge dam in the Ramapo region of the Cats- 
kill Mountains, which formed behind it a huge reser- 
voir of 36 square miles and held back the water from 
an area of over 200 square miles. All this land was 
purchased by the city and the buildings upon it torn 
down, which necessitated removing three or four 
villages and hundreds of farmhouses. 

Aqueducts. The water from this huge Ashokan 
Reservoir is brought to the city through a great 
aqueduct nearly a hundred miles in length, which 
dips under the Hudson River, and siphons up again 
on the other side. It is large enough to supply 
500,000,000 gallons of water a day to the great city; 
the city must have plenty of water to drink and keep 
clean with — otherwise it would stop growing. 

Other cities are spending even larger sums of 
money in proportion and undertaking equally diffi- 
cult feats of engineering to get a proper supply of 
water. Los Angeles, for instance, has built an aque- 
duct to bring water from the Owens River Valley, 
two hundred and fifty miles away, and eight thou- 
sand feet high among the Sierras. In its course, it 
tunnels through three different mountain chains. It 



PURE WATER AND ITS SUPPLY 187 

cost over $24,000,000, but it will be a splendid in- 
vestment, because, on account of its tremendous 
fall, it will supply not only water, but immense 
electric power, and a surplus for irrigation as well. 
Even without power, cities now find that they can 
afford to pay well for an abundant supply of per- 
fectly pure water. A moderate water rent will re- 
turn good interest on the investment. 

Filter beds. Other cities, which are situated near 
rivers or lakes whose water is liable to become impure, 
and which have no hills or mountains within reach, 
can get a perfectly wholesome supply of water by 
putting in reservoirs and filtration plants. These 
filter plants are usually huge settling-basins and 
great beds of sand and gravel, through a series of 
which the water is allowed to soak before it reaches 
the tank or reservoir from which it is pumped over 
the city. They cost a good deal of money to install, 
but not so much as a fifty-mile aqueduct. If care- 
fully watched and intelligently operated, they will 
give a reasonably safe and wholesome supply. They 
need close inspection by the health officials, because, 
especially during floods and freshets, the filters are 
likely to become clogged by the mud and silt in the 
water. Then, rather than let the city run short of 
water, the engineers will sometimes pump unfiltered 
water into the mains. When this happens, an 
epidemic of typhoid is likely to follow. 

How typhoid spreads. We have already seen that 
typhoid fever is caused by the infection of the milk 



188 COMMUNITY HYGIENE 

or water or food-supply of well persons by the dis- 
charges from the body of a typhoid patient. When 
typhoid discharges, or sewage infected with them, 
get into the reservoir or stream supplying a town or 
city, the drinking-water of several thousand people 
is infected. It is astonishing how comparatively 
small an amount of typhoid matter is sufficient to 
infect a whole water system. Again and again the 
drainage from a single house in which was a case of 
typhoid fever has infected a whole city. In one case 
a single family with typhoid fever, who camped for 
a few days upon a slope draining into a reservoir, 
produced an epidemic of over two thousand cases 
in the city which used the water. For this reason 
the whole watershed draining into the basin of a 
reservoir or lake has to be watched and guarded 
constantly to see that no infection of the water 
occurs from diseased human beings or diseased 
cattle. 

Our typhoid death-rate is going down steadily, 
because we are becoming more careful about having 
clean water; but it is still far too high. On an av- 
erage, it is much greater than that of many Euro- 
pean countries. We still lose yearly by typhoid 
fever in the United States over twelve thousand 
lives, at least three fourths of which could have 
been saved. 

Other water-borne diseases. While typhoid fever 
is the most serious disease borne by water, and the 
most readily traceable to its source, it forms only a 



PURE WATER AND ITS SUPPLY 189 

small part of the damage done by impure or dirty- 
water. There are several diseases of the stomach 
and bowels which are carried in polluted water. 
Even though the drinking-water may not contain 
the actual germs of infectious diseases, the presence 
of sewage, factory waste, and decaying vegetable 
matter may make a great many people sick. When- 
ever a city or town, to reduce its typhoid, puts in a 
supply of perfectly pure water, not only does its 
typhoid death-rate drop very much, but its general 
death-rate from other causes is lowered as well. 
For every death by typhoid prevented, three deaths 
from other causes are also avoided. 

Home treatment of water. If for any reason the 
city authorities cannot be awakened to their duty 
to provide a pure water-supply, or from some acci- 
dent the filter beds get out of order, we can still 
protect ourselves by boiling all the water that we 
use for drinking or cooking purposes. While this 
of course will not make dirty water clean, it will at 
least kill all the germs in it and stop it from infecting 
those who drink it. There are a variety of filters 
manufactured and sold for use in the home, but few 
of them are satisfactory or safe for practical pur- 
poses. Those that are attached directly to the 
faucet and allow the water to pass through quickly 
are little better than frauds, for all that they do is 
to strain out the big dirt and let all the really dan- 
gerous dirt and germs in the water pass through. 



CHAPTER XXIV 

SEWAGE AND GARBAGE DISPOSAL 

How we may poison ourselves. Every house, 
barn, shop, factory, and place where men live and 
work gathers heaps of waste, dirt, and fertilizer, 
which, if not regularly removed and burned, will 
decay and become offensive both to the eye and to 
the nose. 

Still, this dirt will do us no serious harm unless it 
gets into our drinking-water or our food. A few un- 
pleasant odors hurt nobody, if the substances from 
which they come are rapidly decaying and entering 
into the soil — as in the case of garden or lawn fer- 
tilizers — or are to be removed and destroyed before 
flies and other insects have had time to breed in 
them. We need not hesitate to use strong-smelling 
and disagreeable fertilizers and dressings upon our 
lawns and gardens, if there is no danger of their get- 
ting into our water-supply, or of their being blown 
into our houses and kitchens in the form of dust. 
Stable manure, for instance, is dangerous only as it 
gathers in heaps large enough to be moist in the 
center and to serve as the breeding-ground of flies. 
Waste and fertilizer, when spread thinly over the 
surface of the soil, rapidly become harmless and 
inoffensive. 



SEWAGE AND GARBAGE DISPOSAL 191 

How nature takes care of sewage. In fact, na- 
ture's method for making waste and dirt harmless 
is through the bacteria of decay. The bacteria of 
decay are much like the bad germs which cause 
typhoid fever and other diseases. But instead of 
hurting us they do us good by breaking down and 
crumbling all kinds of dead matter so that it can be 
washed into the soil, where another group of germs, 
known as the soil bacteria, are waiting to attack it. 

The soil bacteria are an exceedingly powerful 
and useful group of germs. In fact, unless a soil has 
plenty of these bacteria, it will not grow good crops. 
Many of our processes of cultivation, such as drain- 
ing, plowing, and stirring the soil, produce their good 
effect upon crops largely by mixing air with the soil 
and keeping it porous, so that these soil bacteria can 
grow freely in it. 

Dangers of sewering into streams. When houses 
began to be grouped together in villages and towns, 
there was soon not enough ground about each one 
to dispose of either liquid or solid wastes by this 
process of seepage and soil decay. We began to 
dig ditches in which the waste water from the 
houses was carried to the nearest creek or river. In 
water there are a fair number of bacteria much like 
those of the soil. Many plants grow in shallow 
places, and swarms of tiny microscopic plants float 
in the water. All these eat up waste. So long as we 
did not pour too much of this sewage into streams, 
they purified themselves fairly well by means of these 



IQ2 COMMUNITY HYGIENE 

bacteria, and no one's health was injured. It used 
to be said that a stream of moderate size would pur- 
ify itself of any reasonable amount of sewage in from 
three to five miles. 

Conditions changed as the country grew more 
thickly settled. In fact, many of our medium-sized 
rivers flowing through populous districts became so 
full of sewage that not only were their waters quite 
unfit for drinking purposes, but their shores became 
encrusted with a slimy coating of filth and the waters 
grew so dirty that fish could no longer live in them. 

Dangers of sewage in bays and harbors. Even 
where towns or villages were situated upon the sea- 
coast, or close to the mouth of a large river where 
the water was salt and the tides rose and fell, the 
people found it was unsafe to pour their sewage 
directly into the bay or harbor, although the com- 
munity was protected from one of the greatest 
dangers of sewage pollution, because the water was 
salt and could not be used for household or manu- 
facturing purposes. Moreover, the salt in the sea 
water helped to keep it clean. Yet a modern city 
pours out such enormous quantities of sewage that 
even all the tides of a large bay or harbor cannot 
dilute it sufficiently, or sweep it out to sea quickly 
enough to prevent its making disagreeable and un- 
healthful deposits along the shores and wharves. 

Methods of " sweetening " sewage. Instead of 
laying sewer-pipes to empty directly into rivers and 
lakes and bays, it is necessary to carry great out- 



SEWAGE AND GARBAGE DISPOSAL 193 

flow pipes five, ten, or fifteen miles down the coast 
to empty into the open sea. Sewage is sometimes 
caught in large basins or tanks, and purified before 
it is allowed to flow into the streams. Sometimes 
strong chemicals of various sorts are added, which 
remove the odors or cause the dirt and silt dissolved 
in the sewage to sink to the bottom of the tank, 
leaving the water above it comparatively clean. 
This is drained off, and the mud or sludge at the 
bottom of the tank is shoveled into carts and used 
for fertilizer. 

Another method is to make a series of coarse filter 
basins through which the sewage is passed. To a 
limited extent sewage provides its own remedy. 
Being full of decaying material, it is swarming with 
the germs of decay, and — in the case of ordinary 
house sewage particularly — all that is necessary is 
to delay it from twenty-four to forty-eight hours in 
basins or tanks, called septic tanks, and allow these 
germs time to multiply enough to destroy the greater 
• part of the filth which the sewage contains. It is 
surprising how much these tanks improve the condi- 
tion of even the worst ordinary sewage. Unfortun- 
ately, however, they will not deal satisfactorily with 
manufacturing waste or sewage containing strong 
chemicals. 

For a single house or group of houses, or for a 
sewer draining a residence district or suburb, the 
establishment of such a tank will take care of the 
sewage at a very moderate expense. A septic tank 



194 COMMUNITY HYGIENE 

to deal with the sewage from an ordinary house 
can be constructed for about ten dollars. When 
properly managed, the liquid which flows away 
from it will be almost free from odor and clean 
enough for fish to live in, although, of course, it will 
still have a good many germs in it. Such a tank 
is much superior to the old-fashioned cesspool, 
which was simply a pit dug in the ground, roofed 
over, and covered with soil, into which the house 
drains emptied. If the soil was sufficiently porous 
and the cesspools far enough away from any house, 
it would often dispose of the water fairly well; but 
in clay soils, and at rainy seasons of the year when 
the soil became water-soaked, it would overflow and 
become offensive and unhealthful. 

Sewer-pipes and traps. In towns and cities it is 
important that the sewage from the houses should 
be carried in pipes separate from the drains that 
carry away the storm water from the streets. In the 
old days sewers were made to carry off all the water 
which was to be drained away. Consequently the 
pipes had to be of enormous size. The famous 
sewers of Paris are large enough to allow a boat 
to float down them, and to permit men to walk 
through them upright. Once they were actually 
used as hiding-places for thieves and for stolen 
goods. In sudden heavy rainfalls, however, the 
largest sewers may become choked with storm water, 
and the sewage from the houses which trickles 
down at very much lower pressure may be forced 



SEWAGE AND GARBAGE DISPOSAL 195 

back up the pipes and may flood the cellars or 
rooms. 

The flow of ordinary house sewage is steady, and 
requires a pipe of only about one tenth of the size 
needed to carry away flood water. It is dangerous 
to have a sewer-pipe too large, because, unless the 
pipe is small enough to keep a current flowing 
steadily through it, rilling it at least half or two 
thirds full, the filth dissolved in the sewage will dry 
and deposit along the edges. Before long the pipes 
are choked with this deposit, which soon begins to 
decay and gives off the once much-dreaded sewer 
gas. Being lighter than air, this gas, instead of 
flowing down with the sewage, rises uphill through 
the pipes, and finally works its way back into the 
houses themselves. To prevent this backing-up of 
gas, it is customary to put in each drain-pipe a 
U-shaped or S-shaped bend, known as a trap, which 
always remains full of water and prevents the gas 
from flowing back. Although these traps are still 
used to prevent any accidental gas formation and 
return, they are scarcely necessary in these days 
when sewers are made of small size, with tight joints 
and smoothly glazed inner surfaces. Besides, while 
sewer gas is disagreeable, it is not seriously danger- 
ous to health. 

Garbage-cans and carts. Liquid waste or wastes 
that can be dissolved readily in water are best dis- 
posed of through sewer-pipes. In the country, the 
solid waste from the kitchen is fed to pigs and 



196 COMMUNITY HYGIENE 

chickens. In towns and cities this method of gar- 
bage disposal is out of the question, and each house 
is required to provide itself with two garbage-cans, 
one for food scraps and the other for ashes, tins, 
bottles, and other dry waste. These cans are col- 
lected, under the management of the health depart- 
ment or the street-cleaning department, by carts 
which carry the garbage away to be burned or buried. 

Garbage-carts are usually made of iron to prevent 
leakage of any liquid garbage as they are being 
driven through the streets, and they should have 
tight covers to prevent the lighter portions of the 
garbage or dust from the ashes from being scattered 
about the streets. 

Burying, burning, and reducing garbage. One of 
the most annoying city problems is that of the final 
disposal of garbage. In an earlier day, people used 
to dump the garbage in some field or lot at a distance 
from the edge of the town. This quickly bred abomin- 
able smells and swarms of flies which the wind often 
carried back to the town. If the town grew, the 
garbage-dump became a nuisance to the outlying 
houses. 

Cities built by the sea or near large lakes piled 
the garbage into scows, towed it several miles out, 
and dumped it overboard. After this process had 
gone on a few years, it was found that the garbage 
had a way of coming back. The shores of the lake 
or river or the bathing-beaches far down the harbor 
would be fringed with unpleasant scraps and refuse. 



SEWAGE AND GARBAGE DISPOSAL 197 

A somewhat better method was to establish a re- 
duction plant in the suburbs at some distance from 
the city. Here the water was squeezed or cooked 
out of the garbage, the grease or fats were extracted, 
and the remainder burned or turned into commer- 
cial fertilizer for use on farms. This was more 
cleanly than the dumping processes, and had the 
advantage of saving money for the city, because 
the grease and fertilizer from the garbage were 
valuable enough to make the contractors willing 
to collect the garbage, or even to pay the city to 
deliver it to them. Unfortunately, the reduction 
plants produced offensive odors, and caused a great 
deal of complaint for miles in various directions, 
according to the direction of the wind. The sub- 
stances recovered from the garbage were often used 
for questionable purposes. The grease was em- 
ployed in the manufacture of soap, and it was even 
whispered that, by some special deodorizing process, 
it was turned into imitation butter. On the whole, 
this method proved more or less unsatisfactory. 

There are only two forms of disposal which are 
cleanly, efficient, and wholesome. One is to burn 
the garbage in specially constructed furnaces known 
as incinerators. The ashes and garbage are mixed 
together, for it has been found that there is enough 
unburnt coal in ashes to burn the garbage when 
a forced draft is supplied. The fumes which rise 
from the burning are driven by fans through pipes 
which carry them back again and again through the 



198 COMMUNITY HYGIENE 

furnace until they are entirely consumed. The chim- 
ney of a good garbage incinerator makes no visible 
smoke, and everything brought to it is turned into 
clean, odorless ashes within ten or twelve hours. 
These garbage incinerators are as inoffensive as 
any ordinary manufacturing plant, and can be es- 
tablished at any point convenient for the collection 
and delivery of the garbage. Such plants cost con- 
siderable money to install, but the large amount of 
heat generated may be used to furnish power for 
manufacturing purposes or for lighting the city or 
for running its street-car system. 

The other satisfactory system is much less ex- 
pensive, but is somewhat liable to be interfered with 
by stormy weather or severe cold. It is based on 
the old method of burial. A region of ground from 
ten to forty acres in extent, according to the size 
of the city, is set apart, and trenches four or five 
feet deep are scraped across it at regular intervals. 
Each day the garbage is deposited about two feet 
deep in the trenches, sprinkled with coal oil or some 
chemical to prevent fly-breeding, and covered with 
earth to a depth of eighteen inches or two feet. By 
the time the entire surface of the area has been 
trenched and covered in this manner, the garbage 
in the trench first filled has so completely decayed 
that a new trench can be dug and the process started 
across the tract again. One acre of land for each 
ten thousand people is enough. 



CHAPTER XXV 

STREET- CLEANING AND PAVING 

Where dust grows. Dust is not only unpleasant 
to look at, but it is a very serious danger to health. 
Indeed, next to sewage and garbage, it is probably 
one of the most unwholesome things with which 
we have to deal, particularly in cities and towns. 
Dust in the country, which blows from the surface 
of ordinary dirt roads, or from cultivated fields, may 
not be dangerous to health. City dust is quite a 
different matter. In winter a considerable part of it 
is composed of soot and fine ashes from coal smoke. 
This, though disagreeable, is not especially danger- 
ous to health. 

But street dust which blows from the pavements 
swarms with bacteria of all sorts, and is most un- 
wholesome. About half of it is dried horse-manure. 
Add to this the germs of catarrh, bronchitis, and 
tuberculosis which have been expectorated upon the 
pavements, and you have as unwholesome a mix- 
ture as could well be imagined. 

The other town and city dusts which come from 
various manufacturing processes are almost equally 
unwholesome. The fumes from chemical works or 
blast furnaces are irritating and poisonous. The 
lint from cotton or woolen mills, or the dust from 



200 COMMUNITY HYGIENE 

flour mills, furnishes an excellent breeding-ground 
for germs. 

How dust gets into our systems. The chief danger 
of dust is that it is so light and fine that it can be 
blown about by the wind. The commonest way for 
dust to get into our systems is through our noses 
and throats. Many of our most serious diseases 
enter in this way. Curiously enough, germs seem to 
be more dangerous to health when mixed with dust. 
Probably the irritation of the dust in our noses and 
throats inflames the mucous membrane and cracks 
it so that germs may gain an entrance into our 
blood. Certain it is that several very dusty trades 
are likely to cause tuberculosis in those employed at 
them. In some of these trades the dust itself is com- 
paratively free from germs. For instance, the dust 
from the emery wheels used in sharpening knives 
and tools causes in the workmen a form of con- 
sumption which used to be known as " knife- 
grinder's asthma." The dust raised by chipping 
stone or marble with a chisel is likely to give rise to 
consumption in masons and stone-cutters. One of 
the most dangerous dusts of all is the fine black 
carbon dust from dried printers' ink, which floats 
about in printing-shops and pressrooms. Dust is 
also blown upon our food, or scattered over our 
clothing and hands, and then carried into our mouth 
in the process of eating. 

How dust is kept down. It will be seen that the 
problem of keeping down dust is of great impor- 



202 COMMUNITY HYGIENE 

tance to the community. One of the simplest meth- 
ods of keeping down dust is by various forms of 
sprinkling. In town and village streets the passage 
of the street sprinkler at regular intervals is almost 
a necessity in the summer. 

Sprinkling with some form of crude oil (petroleum) 
has the double advantage of keeping down dust not 
merely for a few hours, but for several weeks or 
months. At the same time it forms a firm, smooth 
coating or pavement. It can be used with excellent 
effect upon city, village, or residence suburb streets. 
The oil helps to prevent flies and other insects and 
kills their eggs wherever it comes in contact with 
them. In the downtown parts of cities this oil 
coating is not so suitable. If applied over dirt or 
macadam roads, the heavy traffic is likely to break 
it up before it can form its dust proof surface. Here 
the problem is met by the use of various forms of 
paving which have a smooth, even, and waterproof 
surface which can be readily flushed down with 
the hose. Different substances are used for this 
purpose, ranging from the rather expensive as- 
phalt to mixtures of cement and creosoted wood 
blocks. 

The main thing is to get a smooth waterproof sur- 
face which can be swept and scrubbed like a bath- 
room floor. Then, if the street cleaners are kept 
busy with broom and shovel all day collecting the 
coarser dirt as fast as it is deposited, at night the 
hose can be turned on the streets and the finer dust 



STREET-CLEANING AND PAVING 203 

and dirt washed down into the gutters and carried 
away through the storm sewers. 

Pavements and health. The problem of paving a 
city or village used to be regarded solely as a means 
of making traffic easy and preventing miring of 
wagons in muddy seasons. Now it is coming to be 
looked upon as an important step in the protection 
of health. The older paving materials, such as 
cobblestones, granite blocks, and wood blocks, kept 
the wheels of the carts and carriages out of the mud 
and rendered it possible to cross the streets in all 
weathers without rubber boots, but they were not 
very satisfactory in other ways. Most of them had 
such a rough and uneven surface that they were 
difficult to clean with either broom or shovel, and 
nearly all of them had cracks into which dirt and 
germs were washed if one attempted to flush them 
with a hose. Wooden pavements decayed and 
became a breeding-place for germs. Asphalt, tar, 
oil, cement, and other smooth-surface pavements 
are much superior for driving purposes to the old- 
fashioned block and cobble pavements, and they 
keep clean, free from filth, and from disease- 
spreading dust. They cost more to lay, but with 
proper care they last so much longer that they are 
a good investment. 

Clean, noiseless, dustless streets. Moreover, 
such pavements reduce the noise of passing car- 
riages and wagons more than fifty per cent. They 
shed the water quickly and completely into the gut- 



204 COMMUNITY HYGIENE 

ters and sewers, and consequently dry very quickly 
after rain. They give almost constantly a dry sur- 
face for children to play and adults to walk upon, 
and hence there is much less moisture in the air of 
cities than in corresponding areas in the country 
during the rainy season. Taken in connection with 
the surface covered by houses and by water-tight 
sidewalks, and the drainage afforded by sewers, one 
sees that from one half to two thirds of the surface 
of our cities is practically roofed over, and the soil 
beneath it kept dry, porous, and wholesome the 
whole year round. 

Streets as playgrounds. We are coming to look 
at our city streets from another point of view — 
that of playgrounds for children. If it were not for 
the danger from traffic, the cement sidewalks and 
clean asphalt pavements would provide wholesome 
and admirable places for children to play. 

As in many crowded districts the streets are the 
only playground available, they are now being 
made safe for this purpose by restricting traffic 
along certain streets in residence neighborhoods. 
These streets are closed to wheeled traffic during 
certain fixed hours of the day. 

Streets as gardens. While streets were origi- 
nally laid out merely to allow foot passengers and 
wagons to get about to the different houses along 
them, it has been found that there is a great deal 
more space than is actually needed for traffic. 
Streets, therefore, are being used to let in air and 



STREET-CLEANING AND PAVING 



205 




A CITY PLAY-STREET 



Part of a street in a crowded city district closed to traffic 
have a place to play. 



that the children can 



light and to provide places for recreation and exer- 
cise. Some kinds of traffic, such as street-cars, drays, 
heavy wagons, etc., are kept on certain streets, and 
other streets are turned into road parks or recreation- 
gardens by taking strips down the center or along the 
side and planting trees, grass, and flowers. As street 
railways and automobiles gradually take the place 
of horse-drawn wagons and carts, it seems probable 
that some day more and more of the city traffic will 
be run through open or closed subways. By using 
the space saved in this way from wheeled traffic, all 
but our busiest trunk-line streets may be turned 
into a series of attractive public parkways. 



CHAPTER XXVI 

PARKS, PLAYGROUNDS, AND SWIMMING-POOLS 

The green lungs of the city. Cities are like ani- 
mals, not only because they grow and have to be fed, 
but because they need plenty of air to breathe. 
In the beginning they are so small and so loosely 
constructed that they have about them all the air 
they need. The country end of every street is an 
open mouth to draw in pure air, just as a living 
sponge or a sea anemone absorbs air from the sea 
water through the pores all over its surface. 

When cities grow to be miles square, however, 
with thousands of acres of solid blocks of houses cut 
up by narrow streets, with sky-scrapers making the 
main streets look like mountain canyons, and with 
a forest of tall chimneys belching clouds of thick 
smoke, the pure country air loses its purity before it 
is halfway to the business center. Therefore, the 
city must provide breathing-places, or lungs, in its 
interior, into which the fresh air can blow, and where 
children can play on the grass in the pure air and 
sunshine. Parks, open squares, playgrounds, and 
boulevards are literally the lungs and the air- 
passages of a city. They are absolutely necessary 
to its health. 

Where the grass grows, we grow. Until recently, 



PARKS AND PLAYGROUNDS 207 

parks, public gardens, and boulevards were looked 
upon chiefly as ornaments to the city. Strangers 
were taken to see them. People strolled there on 
Sundays or holidays and listened to the band con- 
certs. The place of honor in them was given over to 
beautifully laid-out and costly winding drives and 
roads. Carefully tended flower-beds came next in 
honor, and the grass was kept like a velvet carpet, 
never to be played upon or rolled over. Conse- 
quently, most of our older parks needed to be re- 
arranged in order to make them playgrounds and 
health resorts for the mass of the people. 

The modern view of parks is widely different. 
Though we value them highly as beauty spots and 
civic ornaments, their principal service is to con- 
tribute to the health and comfort of the community. 
Instead of being content with one great landscape 
garden miles away from the crowded parts of the 
city, we are trying to scatter parks over the entire 
area of the city, so that at least each ten thousand 
people shall have a breathing- place, if it be only 
a block in area, and no family shall be more than a 
mile, or fifteen minutes' street-car ride, from a fair- 
sized park. 

This involves the spending of a great deal of 
money, especially since land in the downtown dis- 
tricts has become so high-priced; but in the end it 
will be worth all its cost. Children cannot grow 
strong except where the grass grows; and no city 
can call itself great or hope to continue prosperous 



208 COMMUNITY HYGIENE 

which does not make itself a wholesome, happy 
place where children may play and grow to strong, 
healthy manhood and womanhood. This is the aim 
of one of the most wonderful world movements of 
our time, that of city planning and city beautifying, 
upon which millions of dollars are being spent every 
year in every country of the civilized world. 

Play-places for children. Instead of putting 
" Keep Off the Grass " signs everywhere, the first 
thing a modern park provides is abundant play- 
places for children. Some of these are stretches of 
soft green turf, carefully graded and drained so as 
to dry out quickly after a rain, where children may 
roll and tumble and play to their hearts' content 
whenever the weather permits. Others are broad 
stretches of sand and gravel, also carefully drained, 
so that they never become muddy or puddled. 
Large sand-boxes are placed at each corner, and 
swings, merry-go-rounds, seesaws, and stretches 
where the simpler games can be played, are fur- 
nished. As these can hardly be made ornamental in 
appearance, they are usually screened with rows of 
bushes and fringes of trees, under which seats are 
arranged for nursemaids and tired children. 

Swimming and wading pools. In addition to the 
purely ornamental ponds, special wading pools are 
constructed. These are shallow basins dug in the 
ground. They measure from fifty to one hundred 
and fifty yards across, and are not more than two 
or three feet deep in the center. They have cement 



PARKS AND PLAYGROUNDS 209 

bottoms and sandy shores, are filled from the hy- 
drants, and are provided with escape pipes like those 
of bathtubs. They can easily be emptied and thor- 
oughly cleaned at regular intervals. In warm 
weather children can wade in these pools and splash 
and sail boats and fish for imaginary minnows. In 
winter they can skate on them with perfect safety. 
One or two of the larger pools have bottoms care- 
fully graded and artificial beaches laid down so that 
they can be used as swimming-places in hot weather. 
Dressing-rooms and shower baths are provided on 
the shore. 

Playgrounds for boys and girls. Other parts of the 
park, screened with trees and shrubbery, are de- 
voted to sanded and graveled spaces where base- 
ball, football, and all kinds of running games can 
be played. Other portions are devoted to lawn- 
tennis courts, and in the largest parks golf links are 
laid out. In the outlying parks handsome athletic 
grounds are arranged, with running-track, football 
gridiron, baseball diamond, and a public stadium 
where games and sports can be held and open-air 
concerts or pageants given. 

Open-air lunch-rooms, cafes, and model dairies. 
All modern parks now make a special point of pro- 
viding plenty of places to eat in the open air. In- 
stead of selling restaurant and lunch-room privi- 
leges to private individuals, the city now supplies 
the food — in some cases at cost ■ — ■ or else rigidly in- 
spects and certifies everything served on the stands. 



210 COMMUNITY HYGIENE 

Not only are restaurants provided near music- 
stands or boat-houses, but little kiosks where simple 
lunches, pure candy, fruit, ice-cream, and pure soft 
drinks may be purchased are scattered all over the 
grounds. Also there are pavilions with benches and 
tables where those who bring their own lunches may 
eat them in comfort. In many of the European 
parks small model dairies are established, with half 
a dozen high-grade cows in a model and carefully 
kept stable and milking-shed. The children not 
only can buy pure milk and cream to drink with 
their bread and butter and cakes, but get an object 
lesson as to how dairies should be conducted to 
keep the milk pure and wholesome. 

People's country clubs. In some of our most pro- 
gressive park systems, like that of Chicago, for 
example, country clubs are built in the different 
parks. These are provided with hot and cold baths, 
a swimming-pool, a gymnasium, a library, a dining- 
hall, a concert-room, a restaurant, and all the 
equipment of an ordinary private country club. 
They are open to any one in the community. In 
one of them, situated not far from the Chicago 
stockyards district, fifteen hundred hot baths are 
often taken in a single Saturday afternoon and eve- 
ning; while the visitors to the library, the restaurant, 
the reading-room, and the gymnasium are numbered 
by tens of thousands. 

Picture galleries, museums, and zoos. Institu- 
tions of this sort have always been considered orna- 



Courtesy Russell Sage Fo 




■ 61 






Courtesy Town Koom, Boston 

WINTER AND SUMMER AT A CIVIC PLAYGROUND 
Skating in winter and swimming in summer are most healthful exercises. 



212 COMMUNITY HYGIENE 

merits of city parks and their value is even more 
widely recognized to-day. Every region of a great 
city should have within easy reach such an institu- 
tion which is a means of pleasure, education, and 
culture for the neighborhood. Some cities have large 
halls for the permanent display of objects of local 
historical interest, or of the products of the region 
or State. Expositions, exhibitions, and various kinds 
of educational displays can be held in them from 
time to time. 

Band concerts and dance pavilions. Last, but by 
no means least, the modern park has plenty of band- 
stands surrounded with circles of benches, where 
concerts can be given in pleasant weather. Many 
of them have halls in which concerts are given in the 
winter or in stormy weather. 

The most attractive features of a city park are 
its level greens, open-air dancing-floors, and roofed 
pavilions, for public dancing. Folk-dances and 
morris dances are among our most valuable gymnas- 
tic exercises. These dancing-greens and pavilions 
form one of the most popular features of our parks. 
The order maintained and the character and refine- 
ment of the dances and entertainments conducted 
have been most satisfactory. Many cities are fol- 
lowing the lead of Chicago, and establishing mu- 
nicipal dance-halls in the downtown and residence 
districts for dances and entertainments of all sorts 
in the winter months. 



CHAPTER XXVII 

HOUSES AND STREETS 

Our right to a healthful and beautiful home. 

Houses are places in which to enjoy life. Almost any 
house with plenty of room, a water-tight roof and a 
dry cellar, a good chimney and plenty of windows, 
can be made into a comfortable and pleasant home. 

As long as houses were dotted about on farms or 
built on village or town streets with large lots and 
grounds, there was little trouble in making them 
healthful and attractive. A pretty garden is worth 
three best parlors; and a green lawn or a creeper- 
covered piazza adds to the healthfulness and pleas- 
ure of life. A pretty cottage with green grass and 
flowers and sunshine on every side, with simple fur- 
niture, fresh paint, and clean white curtains, is a 
home fit for a king. 

But when houses are wedged in solid ranks on 
each side of a city street, with a narrow front yard, 
a narrow back yard, and no side yards at all, it is 
very difficult to make even a ten- or fifteen-room 
house with bathroom and furnace a really healthful, 
comfortable, livable home. To such an extreme has 
this crowding gone that the central rooms in many 
city houses are almost completely cut off from light 
and air. This has become such a serious cause of ill- 



214 COMMUNITY HYGIENE 

health that most cities have passed special building 
and housing laws, requiring houses to be built a 
certain fixed distance apart, not to cover more than 
a certain share of the lot, and insisting that courts, 
open spaces, or air-shafts shall be provided so that 
every room in the building shall have at least one 
window and enough light to allow ordinary print 
to be read in the room during the hours of daylight. 
How houses become disease-breeders. These 
laws lay down certain rules for building all new 
houses, and also provide that, wherever older houses 
have been built with windowless rooms, changes 
must be made to let in light. At first sight, perhaps, 
this seems rather meddlesome; but when a careful 
study of the situation in New York, for instance, 
showed that there were over three hundred thou- 
sand dark rooms in New York City alone, it was 
clear that something must be done. Studies made 
by the city health authorities and housing com- 
missions quickly showed that the deaths, particu- 
larly from tuberculosis, of people who slept in these 
dark rooms were from three to five times as great 
as those of the rest of the community, and that 
the smaller the number of rooms and the darker the 
rooms into which the families were crowded, the 
higher was the death-rate and the greater the amount 
of disease. Even the children who grew up in two 
or three rooms with poor light and air were several 
inches shorter at seventeen than those who lived in 
larger apartments in better parts of the town. 



HOUSES AND STREETS 



215 



This most unhealthful condition arose almost by 
accident. In every city it is invariably the old houses 
which are the worst. Many of them were originally 
built in open spaces, and as long as they stood in 
private grounds with plenty of air and light about 
them, they were wholesome, .comfortable homes. 
Then the neighborhood gradually became unfash- 
ionable. Land went up in value. New houses were 
crowded in between the old structures, porches that 
had looked out over gardens were closed in and 
turned into rooms, large houses were cut up into 
suites to accommodate six or eight families, and in 




THE ONLY PLACE THEY HAVE TO PLAY 

Do you think these boys would play on a slippery, icy street if the city had parks, 
or neighborhood playgrounds, or community centers ? Do you think it would be 
better for these boys if they had a playground ? Why ? What do you think of 
their city. 



216 COMMUNITY HYGIENE 

a little while the neighborhood became a human 
rabbit warren. 

This overcrowding and self-suffocation and self- 
infection has come to be regarded as one of the most 
serious dangers to the health of our citizens. Proc- 
esses like this have built up the famous " Lung 
Block " in New York City, for instance, where the 
number of cases of consumption and deaths from 
tuberculosis was three times as great among its nine 
hundred tenants as in the rest of the ward, and five 
times as great as that of the general average of the 
city. 

Planning the city for health and beauty. For- 
tunately, the disease of overcrowding carries with 
it its own remedy, if we have the sense and courage 
to apply it. The same high price of land and high 
rents which cause the overcrowding make it profit- 
able to tear down these wretched old shacks and 
build healthful model tenements in their place, from 
the rents of which the owner can realize a reasonable 
percentage on his investment. When the old rook- 
eries are near the wholesale or manufacturing quar- 
ter of the city, it is possible to tear them down and 
erect office buildings, factories, or shops in their 
place, providing model tenements or cottages in the 
suburbs and cheap transportation for the former 
tenants. Where the property owners are not pro- 
gressive and public-spirited enough to do this, most 
European cities purchase the land and erect model 
dwellings or make such changes as are necessary to 



HOUSES AND STREETS 217 

protect the health of the workers. In most cases, the 
only reason why private owners refuse to put in 
suitable houses and tenements is that they are mak- 
ing an enormous percentage of profit on their origi- 
nal investment. Since from these disease-breeding 
old houses the owners can secure fifteen, twenty-five, 
or even thirty-five per cent per annum interest, they 
are not anxious to exchange this income for a rea- 
sonable six or seven per cent, no matter how much 
their profit costs in human life and human suffering. 

In all modern European cities, and in many of the 
most progressive American communities, the city is 
avoiding this danger by laying out and planning in 
advance its streets and parks, houses, lots, and 
manufacturing districts. A well-managed municipal 
plan promotes the health and comfort of the entire 
community, as well as adding greatly to the beauty 
of the town and the pleasure of living in it. 

The best time to plan a city is when it is first 
founded; but since nearly all American cities began 
as small villages and did not know in advance how 
big they were going to be, we have to do the best 
that we can by remodeling the older parts and seeing 
that all the new parts and suburbs of the city are 
built up on beautiful and healthful lines. 

The zone plan. The best method of doing this is 
carefully to map out and study the situation in the 
different regions of the city, establish a community 
center, and then divide the city into a series of broad 
rings or belts around it, known as zones. 



218 COMMUNITY HYGIENE 

The central or business part of the city will 
usually be divided into three districts: the re- 
tail, or shopping, district; the wholesale, or ware- 
house, district; and the manufacturing, or railroad, 
district. The next belt surrounding this central 
district will be Residence Zone One ; the next, Zone 
Two; and so on out to the open country, according 
to the size of the city. Rules are laid down for each 
of these zones, chiefly with reference to the height 
of the buildings in proportion to the width of the 
street upon which they face, their nearness to one 
another, and the percentage of the total area of the 
lot which they are permitted to occupy. These rules 
prevent crowding. 

Remodeling the city. Then the city proceeds to 
widen narrow streets, straighten crooked ones, cut 
through such new ones as are needed in the down- 
town districts, and lay out broad boulevards con- 
necting the center of the city with the different sub- 
urbs and with the parks, public buildings, museums, 
art galleries, etc. The most radical change is usually 
in the manufacturing zone. This zone is always 
placed in such a direction from the center of the city, 
that the prevailing winds blow from the city toward 
the factories, in order to carry all smoke, fumes, and 
dust away from the crowded center and from the 
residence district. The railroads are given space for 
their freight yards in this section. This method makes 
it sure that no matter how large a city may grow, no 
part of it can become overcrowded and it will still 



HOUSES AND STREETS 219 

remain well lighted, well ventilated, with broad 
beautiful streets and parks in every section. Many 
of the European cities own their street-railway sys- 
tems and are rapidly buying up all the vacant land 
within and around their limits for two and three 
miles in every direction. 

Street-parking and gardens. The great objection 
to city remodeling and planning is that it seems 
expensive; but this expense is only apparent. The 
saving of the waste from sickness, suffering, and 
deaths is so great and the increase in the earning 
power and efficiency of the community is so marked 
within ten years that it pays back into the city 
treasury four or five times as much as it costs. If 
this skillful and intelligent planning is done in ad- 
vance for new cities, and for new parts of old cities, 
there is no additional expense, but rather a saving 
all along the line. Private real-estate and building 
companies now are finding that it pays them well 
to devote from ten to twenty per cent of the land in 
their new suburbs or additions to parks, gardens, 
and playgrounds. People are beginning to demand 
these things as necessities of life, health, and com- 
fort; and a suburb or building addition provided 
with them attracts more purchasers and a better 
class of tenants. The more that cities or people 
spend in improving their health and increasing their 
comfort and promoting the comfort of life, the better 
it is for all the people living in them. 



CHAPTER XXVIII 

OUR INSECT ENEMIES 

Why we fight insects. Within the last thirty 
years we have discovered that some of the smallest 
things are the most dangerous. The deadly disease 
germs which cause sickness and often death are so 
tiny that they must be placed under the strongest 
microscopes to be seen at all. Within the last fifteen 
years we have discovered that the greatest carriers 
and spreaders of these disease germs, and the most 
serious wasters of our crops, are insects. 

We have always disliked insects. They crawl, 
they buzz, they get into things, and they bite. But 
we have regarded them as nothing more than an an- 
noyance, and have even made a joke of them. For 
instance, nobody took a mosquito-bite seriously. 

Now we have found, much to our surprise, that 
insects are more dangerous to the human race than 
all the lions and tigers put together. The worst ene- 
mies of mankind are not the huge beasts of the 
forest, and not other men, but tiny, feeble, buzzing, 
crawling insects. The real battle for the possession 
of the earth is between us and insects. 

This may seem hard to believe. Yet it is a fact 
that the mosquito Anopheles, which carries malaria, 
and the other mosquito Stegomyia, which carries 



OUR INSECT ENEMIES 221 

yellow fever, cause at least half a million human 
deaths every year in the entire world, and an enor- 
mous amount of sickness and suffering besides. The 
tiny jumping rat-flea which carries the bubonic 
plague germ, has a recent record of nearly ten mil- 
lion deaths in India and China alone during twenty 
years. The hookworm is estimated to infest the in- 
testines and suck the blood of over two hundred 
million people in the tropics and subtropics. Indeed, 
it is more than probable that in the tropics insects 
have kept man half-civilized, stupid, and feeble, and 
that this is the principal reason why no lasting high- 
grade civilization has ever yet grown up there. 

The best general rule to lay down is to kill 
swiftly and painlessly every insect that comes within 
reach. It sounds bloodthirsty and cruel, perhaps; 
but unless we kill the fly and the mosquito, they will 
do their best to kill us. 

Insects that eat our bread. In addition to the 
human suffering caused by insects which carry dis- 
ease germs, insects also are the principal enemies 
with which the farmer and fruit-grower have to con- 
tend. The United States Department of Agricul- 
ture estimates that the annual loss in the farms and 
orchards of the United States by the ravages of in- 
sects is over $100,000,000 a year. 

Protecting the birds is the first and most far- 
reaching step in a campaign against insect enemies. 
The birds are our best allies. A few of them, it is 
true, eat some of our fruit and grain; but this is a 



222 COMMUNITY HYGIENE 

small reward for the enormous help they give us in 
killing our insect enemies. Though many birds live 
largely upon grain, seeds, and fruits, most of them 
eat thousands of insects the year round, and all of 
them gather large numbers of insects during the 
weeks when they are feeding their nestlings, because 
all young birds require insect food. 

Swallows live largely on gnats, to which family 
all mosquitoes belong. There is an old folk saying 
that wherever swallows build their nests the air is 
wholesome, and probably the real reason for this 
saying is that they make it wholesome by destroying 
the pestilent gnats, mosquitoes, flies, and other in- 
sects. In other words, our birds not only protect 
our health by protecting our food from insects, but 
by eating the insects that carry disease germs. 

So make pets and companions of every bird about 
the garden, or orchard, or barn or woods. They will 
not only sing for you and delight you with their 
beauty and grace, but they will stand between you 
and hunger and between you and disease like a liv- 
ing, fluttering wall of eager beaks and nimble wings. 

The insect and the worm. The term " insect " in- 
cludes not merely beetles, grasshoppers, butterflies, 
flies, and bugs, but also about ninety per cent of our 
common worms — the army worm, the cutworm, 
the wireworm, the apple worm, the cabbage worm, 
etc. All of these come from the egg of a flying insect, 
and after a little time they will change into flying 
insects themselves — beetle, moth, butterfly, or fly, 



OUR INSECT ENEMIES 223 

as the case may be. The flying insect flutters about 
and lays its eggs. The eggs hatch into a worm-like 
creature — " wiggler," maggot, caterpillar, or what- 
ever it may be termed. This stage of its growth is 
called the larva stage. By and by the larva goes into 
a chrysalis, from which it hatches out into the full- 
grown flying insect again. Practically all so-called 
"worms," except the angleworm and the tape- 
worm, are really the larvae of insects. 

While it is difficult to catch and destroy the flying 
insect, it is quite possible to attack successfully most 
insects when in the egg or the worm stage. In fact, 
three fourths of the war against insects, both crop- 
destroying and disease-bearing, consists in keeping 
them from hatching out of the egg or growing into 
the mature insect. 

Fighting the mosquito. First and most important 
of the insects we must fight is the mosquito. He is 
almost as common as the fly, and there is no ques- 
tion about the certainty and deadliness of the dis- 
ease he carries. After he is hatched, it is impossible 
to try to destroy him. The main point of attack 
upon him is the pool in which he breeds. Mosquitoes 
can hatch only in standing water. If there is no 
standing water, there are no mosquitoes. Drain the 
pools and sloughs and low places within five hundred 
yards of your house, and you will have few mosqui- 
toes, except when a strong wind blows them up from 
distant swamps or cattle and horses carry them up 
from the river or pond. 



224 COMMUNITY HYGIENE 

Inasmuch as three fifths of the earth's surface is 
covered with water, this does not seem to give us any 
particular grip on the mosquito. But fortunately he 
cannot breed in running water. It is only in small 
pools of stagnant water that he can develop, or in 
the quiet water that occurs among the grass and 
lily-pads around the edge of a larger body of water. 
Why? Because the action of the waves which have 
a chance to be raised by the wind on a large pool 
drown all the mosquito larvae that might be 
hatched. Also certain fish that live in shallow water 
devour the larvae. Consequently every pool bigger 
than an ordinary barn floor, providing its edges 
are kept free of grass, weeds, etc., will not breed 
mosquitoes. The mosquitoes which you see over 
rivers, streams, and lakes have not been hatched 
in open water, but in little puddles of rain-water 
or little hollows left full of water as the pond dries 
up and shrinks during hot weather, or among 
the grass growing in shallow places along its edge. 
It is even possible that many come from some 
rain-barrel, or cans in which water is caught, 
around a neighboring house, for such accumula- 
tions of stagnant water are frequent, though unsus- 
pected, sources of mosquitoes in the neighborhood 
of houses. 

How do we know that these things are true? 
Take the case of the great salt marshes and the 
swamps along lakes and rivers. Many of these areas 
have been completely freed from mosquitoes by 



OUR INSECT ENEMIES 225 

simply digging ditches from these"scattered pools so 
that the water may be drained off before it has time 
to breed mosquitoes. Then care is taken to keep the 
ditches clear and free from growth, so that the flow- 
ing of the water will not be hindered, and the pools 
will not be formed again. 

But what are we going to do with places which 
cannot be drained and yet are not large enough to 
be much affected by the wind? The answer is, Use 
oil. This may be in the form of kerosene, or a mix- 
ture of kerosene and crude petroleum. The mixture 
is usually used for large operations and the kerosene 
for small ones. The oil should be applied very early 
in the spring, for while most mosquitoes require a 
pool of water that lasts three or four weeks in order 
to hatch their eggs and bring them through the 
"wiggler" stage in safety, they can live in very cold 
water and hatch in the almost freezing pools of 
water left by the melting of the snow in the spring. 
So these little early spring pools and sloppy places 
should be sprinkled with kerosene if the woods and 
brush patches are to be free from mosquitoes in sum- 
mer. The kerosene acts partly as a direct poison, 
and partly by making a film over the surface of the 
water. This cuts off the air so that the tiny "wig- 
glers" can get none to breathe when they come up 
to the surface. 

Municipal mosquito campaigns. Mosquito cam- 
paigns are now regarded as a part of the regular 
work of progressive boards of health, just as street- 



226 COMMUNITY HYGIENE 

cleaning and pure-milk supply and sewage disposal 
are managed by the city; and a great many places 
in the United States which were formerly infested 
with mosquitoes all summer are now almost entirely 
free from them. Even the famous Hackensack 
marshes of New Jersey and the salt-water swamps 
around Staten Island have been made fit for people 
to live in during the summer; and several areas 
along the New England coast, notably Connecticut 
just north of New York City, have been made al- 
most mosquitoless summer resorts. 

In other words, if the health officers and property 
owners will work together, they can rid any town, 
village, or summer colony of mosquitoes within two 
years. The only thing that the town has to do is to 
make up its mind that it will not permit the mosquito, 
and persist in draining and kerosening until the pest 
is wiped out. 

What to do with the fly. "Swat the fly" has 
come to be a common phrase; but the real place to 
attack this pest is at the same point in his life career 
as the mosquito — at the breeding-ground where the 
eggs hatch and the worms or maggots develop into 
the full-grown insect. 

There are nearly three thousand species of flies, 
each one numbering its hundreds of millions. Out 
of these three thousand, however, there is only one 
which causes us serious trouble — the house-fly, 
Musca domestica. As his name suggests, he is a do- 
mestic insect living in the piles of dirt and rub- 



OUR INSECT ENEMIES 227 

bish which gather in barnyards, back gardens, and 
alleys, and the campaign against him is a never-end- 
ing campaign of cleanliness. You may haul away the 
manure and clean up the garbage piles and make 
everything about garden, barn, and alley tidy, offer- 
ing no place for a single fly to lay her egg ; but unless 
you are always on the watch, the manure-pile will 
gather again, and the dirt-heaps reappear, and in a 
little while you have it all to do over again. 

On the other hand, the fly is easier to get at than 
the mosquito, because he lives on the same lot with 
us; and the cleaning of each individual back yard 
and barn takes much less time and money than the 
draining and kerosening of mosquito pools. Besides, 
it is so pleasant to have our surroundings whole- 
some and orderly and clean that it would be worth 
while to clean up our yards even if it were not for the 
fly. Every fly is a sign of hidden dirt somewhere, and 
is a disgrace to the neighborhood where he is found. 

Every fly, moreover, is a disease-carrier. His hairy 
legs and feet are covered with every kind of dirt 
and filth to be found in the neighborhood, which he 
carries to the kitchen and leaves on our food, our 
tables, our furniture, our bedding, and on our faces 
while we sleep. There is no excuse for his existence, 
and every reason for getting rid of him. 

As in the case of the mosquito, it is of little use to 
waste time with fly-papers, fly-traps, or " swatters " 
after the insect is full-grown. The way to destroy 
him is to destroy his breeding- pi ace. 



228 COMMUNITY HYGIENE 

It takes from eight days to several weeks, depend- 
ing on the temperature and food, for the fly to hatch 
out, grow through the maggot stage, pass into the 
brown chrysalis, and come out as a full-grown insect. 
During this period he must have abundance of food. 
He likes best decaying vegetable matter, such as 
horse-manure which is soft enough to be easily 
eaten, and yet porous enough to let in the air which 
the maggot needs while he is growing. 

If the manure-heap is too wet and soggy, the eggs 
cannot hatch in it for lack of air; and when the ma- 
nure cannot be hauled away often, the hatching of 
flies may be checked by wetting the heap down thor- 
oughly with the hose and sprinkling borax on it. 
Again, if the manure is too dry, the maggots cannot 
hatch for lack of moisture; so that when the manure 
is spread on the land it dries out so quickly as to 
leave no moisture for the maggots to live on. 

There are three ways, therefore, to prevent fly- 
breeding in manure-heaps. First, and best, the ma- 
nure may be thrown directly from the barn into an 
old wagon and carried out to the fields every day. 
Second, in a city barn or stable where only a few ani- 
mals are kept, it may be hauled away regularly 
every week. This is often enough, as the young fly 
cannot then complete its development, if the manure 
is properly disposed of. Third, if the manure cannot 
be hauled away as often as this, or if it is necessary for 
it to be piled in compost-heaps to become thoroughly 
decayed before spreading on the land, and if these 



BABY'S SUMMER NAP 

Screens on the windows, fresh air to breathe, netting to keep off any germ-carry- 
ing fly, a cover over the glass of water to keep it clean. 



230 COMMUNITY HYGIENE 

compost-heaps must be within five hundred yards of 
the house, they may be kept fairly free from flies by 
being sprinkled with kerosene or sulphate of iron 
(copperas), or by wetting down with a strong 
solution of borax. If the manure is to be used for 
fertilizer, the last is the best, because copperas and 
kerosene may injure the growing crops. 

The United States Department of Agriculture has 
prepared a special bulletin giving full instructions 
and careful directions as to the best method of pre- 
venting flies in back yards and barnyards. If you 
will send a two-cent stamp to the Bureau of Ento- 
mology, Department of Agriculture, Washington, 
D.C., a copy of this bulletin will be mailed to you. 

The rat and mouse. Although the rat and mouse 
are not insects, they are included under the head of 
vermin, and they should be mentioned here on ac- 
count of the serious part which they play in the spread 
of disease. 

Though there are many species of wild rats and 
mice, the only ones which give us trouble are two 
domestic species of rats and one of mice. These live 
in and under our barns, our storehouses, and our 
dwellings, and it is only in recent years that we have 
grasped the full extent of the damage and danger due 
to them. It is almost impossible to believe the fig- 
ures of the Department of Agriculture, which esti- 
mates the damage done by rats and mice to food and 
food products in the United States at over fifty mil- 
lion dollars annually, but they are true, It is not too 



OUR INSECT ENEMIES 231 

much to say that one tenth of that sum spent each 
year for five years would exterminate them com- 
pletely and stop all this waste. 

Not only do rats and mice destroy enormous 
quantities of valuable food by eating and gnawing it, 
but they destroy even more by spreading the germs 
of putrefaction and decay. They live and range in 
the dirtiest possible places. From these places they 
bring the germs of decay to our bins, our grain- 
sacks, and our apple-boxes. If you can keep rats and 
mice out of your cellar, you will not only save your 
fruits and vegetables from being gnawed, but you 
will find that they last nearly twice as long and lose 
less than half as much by decaying, shriveling, and 
rotting. 

Moreover, rats and mice not only carry these 
germs of putrefaction and decay to our. food, but 
they also carry the germs of many diseases. We now 
know that the rat is the chief means of the spread 
of that terrible Oriental and subtropical disease, 
the bubonic plague, which sweeps away its millions 
every year in India and China. While we have suc- 
ceeded in avoiding any widespread epidemic of this 
terrible disease in Europe and North America for 
several hundred years, it is by no means certain that 
we can always continue to do so; and if it once se- 
cured a foothold among us, our swarms of rats would 
scatter it broadcast everywhere. On the other hand, 
if we destroy or reduce the number of our rats, we 
shall not only save tenfold the cost of the campaign 



232 COMMUNITY HYGIENE 

by protecting our food, crops, and fabrics from de- 
struction, and by saving our walls and foundations 
from damage, but we shall also be absolutely safe 
against any wide spread of the disease, for without 
rats to carry it the bubonic plague spreads ex- 
tremely slowly or not at all. 

The measures to be adopted against rats and mice 
have already been discussed in the chapter upon 
the cellar. If all cellars, warehouses, corn-cribs and 
barns were constructed so as to keep rats and mice 
out, it would promptly solve the problem. Without 
food and shelter, the animals will starve to death. 
However, where this cannot be done, the number can 
be greatly reduced by the intelligent use of traps and 
of various forms of poison. Poisons, however, should 
be used with great care, for they are also dangerous 
to chickens, dogs, cats, and children. 

Cats are supposed to help keep down rats and 
mice; but for this purpose they have been found to 
be of little actual value. Ferrets and terriers have 
been used by boards of health and farmers' associa- 
tions with much greater effect. Only about one cat 
in ten is of any real use as a mouser, and few cats will 
attack a well-grown rat at all. Moreover, the dam- 
age they do among young birds far outweighs their 
value as mousers, and the germs of disease which 
they carry in their fur is another serious argument 
against them. It is an open question whether they 
should not be included as pests with flies, mosqui- 
toes, and rats. 



CHAPTER XXIX 

THE SPREAD OF DISEASE 

Hpw we crowd one another to death. As we have 
already seen, few diseases grow in the open country 
or spread in the open air; and so far as we can 
trace the origin of our great diseases, consumption, 
cholera, smallpox, anql the Black Death, they seem 
never to have started in thinly populated countries, 
but always in some city or town where people were 
crowded together in narrow streets, breathing one 
another's breaths, and drinking water loaded with 
one another's waste products. It is not necessary 
that these towns should be very large, but only 
badly crowded and unsewered. In fact, a few hun- 
dred people cramped together inside the high walls 
of a mediaeval city no bigger than a modern fort 
would furnish as perfect a breeding-ground for dis- 
ease as a modern city of a hundred thousand inhab- 
itants. It is true that savages and half-civilized peo- 
ples suffer from epidemics of these diseases, but they 
can nearly always be traced to travelers or visitors 
from cities and towns. Even to this day the world epi- 
demics of cholera, the bubonic plague, and influenza 
start from the slums of the great Oriental cities. 

How diseases are passed along. A striking illus- 
tration of how cities breed and spread diseases is 



234 COMMUNITY HYGIENE 

furnished by the recent history of yellow fever. For 
more than two hundred years our Southern States 
have been subject to yellow-fever epidemics at inter- 
vals of from three to five years, — ninety-five epi- 
demics in all, — and a most moderate estimate places 
our loss from them in that time at one hundred 
thousand lives. In 1898, by the chance of war, we 
happened to occupy Havana and to discover the 
cause, or rather the method of spread, of yellow 
fever through the bite of the Stegomyia mosquito. 

Acting promptly upon this knowledge, General 
Leonard Wood and General Gorgas completely 
stamped out yellow fever in Havana and ultimately 
in the whole of Cuba. The almost immediate result 
was that infection stopped coming to New Orleans. 
Partly by English and French colonial sanitary offi- 
cers, and partly by our own army medical officers, 
acting under the invitation of the South and Cen- 
tral American Republics, the process was extended 
to all the larger seaports of the West Indies and 
the Caribbean Sea. In the years since that time 
there has been only one very small epidemic of yel- 
low fever in the United States (1905), with the loss 
of about four hundred lives, compared with twenty 
thousand in 1878. After 1898 there was scarcely a 
death from yellow fever in Havana for ten years, 
and if the cities continue to keep clean, yellow fever 
will become a thing of the past in the United States. 
Clean up the city, and the country will take care of 
itself so far as these great epidemics are concerned. 



THE SPREAD OF DISEASE 235 

There is no proof that even consumption or pneu- 
monia ever started in a savage tribe or among coun- 
try-dwelling people, although they spread among 
such people rapidly when once introduced. 

Light, air, and elbow-room stop disease. Disease 
lives in dirt, grows in darkness, and spreads in foul 
air. If we keep our streets and yards thoroughly 
clean, our cities well sewered, and our houses full of 
light, sunshine, and fresh air, we have taken a long 
step toward making the spread of disease difficult. 
Diseases which used to spread like wildfire in that 
"thousand years without a bath," the Middle Ages, 
could never become a serious epidemic in a modern 
civilized country under up-to-date sanitary condi- 
tions. That does not mean that we may risk bring- 
ing cholera cases into this country, or allow our rats 
to be infected with the bubonic plague. 

On the other hand, one or two diseases, like small- 
pox and typhoid fever, appear to be almost as com- 
mon as ever under modern conditions, unless pre- 
vented by special vaccination or sanitary measures ; 
and a few, like pneumonia, remain difficult to 
control. 

Quarantines. Not only do diseases appear to 
start in cities, but the crowding of large numbers of 
people gives disease a good chance to spread, if 
brought in from the outside. We try to protect our- 
selves against infections, not only by making every- 
thing so clean and wholesome that it will be difficult 
for them to spread, but also by preventing people 



236 COMMUNITY HYGIENE 

with these diseases from coming into the United 
States. 

This is done by establishing what are known as 
quarantine stations at the principal seaports of a 
country or the places where a great railway line 
crosses a state or national boundary. The doctors at 
these quarantine stations require what is known as 
a bill of health from the captain of each vessel coming 
into the seaport, showing that all his passengers and 
crew were examined before they came on board and 
found free from disease ; that he has not touched at 
any port where a disease was epidemic ; and that all 
those on board the vessel are now in good health. 
The doctors of the quarantine station then examine 
all the passengers and crew, and if any of them are 
sick with what is suspected to be an infectious dis- 
ease, or if any have come from a port or country 
where some serious disease, such as cholera or the 
plague, was then raging, such passengers are taken 
to a special hospital, usually on some island in the 
bay or harbor, and kept there until it can be seen 
whether they are going to be sick. 

If cases of serious infectious disease are found on 
board the vessel, the whole ship may be sent to quar- 
antine and ordered to anchor in the bay near the 
quarantine station. No passengers are allowed to 
land until permission is given by the health authori- 
ties. The meaning of the word "quarantine" is a 
curious one ; it comes from quaranta, the Italian word 
for forty, because in earlier times the passengers 




SAVING THE BABIES 

Not only do many cities furnish medical treatment free to their tiny 
they also employ trained nurses to show mothers how to feed, nurse, drei 
keep their babies healthy. 



citizens, but 
:s, wash, and 



238 COMMUNITY HYGIENE 

used to be held for forty days to see whether disease 
was going to break out or spread among them. 

Cases of infectious disease occurring within a city 
are also quarantined. A colored placard is tacked 
upon the side or door of the house, with the name of 
the disease printed on it in large letters, so that peo- 
ple coming near the house may be warned against the 
danger of entering it. Those who are suffering from 
the disease, the nurse, and members of the family 
who are helping to care for them, are not allowed to 
go outside of the premises. Members of the family 
who have work or business outside are carefully ex- 
amined. If they show no signs of the disease, they 
are allowed to continue their business, providing 
they sleep and eat outside of the quarantined house. 
In this way the chance of the spread of a disease is 
greatly lessened ; and if the first five or six cases are 
promptly quarantined, a severe epidemic may often 
be entirely prevented. 

Vaccines. Another special method which is used 
to prevent the spread of diseases, particularly of 
those which do not seem to lessen under civilized 
conditions, is by the use of vaccines. These vaccines 
are cultures, or small colonies, of the germs of the dis- 
ease which is to be prevented. They have been killed 
by boiling, or have been in some way modified or 
weakened so as to make them practically harmless 
in their action. Their use is based upon the fact that 
after a person has had an attack of any very severe 
infection, such as smallpox or scarlet fever or ty- 



THE SPREAD OF DISEASE 239 

phoid, he is usually protected against another at- 
tack for at least a number of years, and often for 
life. This protection is called immunity, and any one 
so protected is said to be immune against that par- 
ticular disease. Indeed, before germs were discov- 
ered or modern science was born, it was a custom in 
many places to expose children and young people to 
the infection of different diseases when these oc- 
curred in a mild form, in the hope that they would 
have a mild attack of the disease and afterwards be 
protected against it for the rest of their lives. This 
was known as inoculation. It was, however, rather a 
dangerous method, because there was no certainty as 
to whether the children exposed would have a mild 
or a severe attack, and while most of them would 
recover, a number were almost certain to die. 

Inoculation was commonly used against smallpox, 
which up to a hundred years ago was a severe or fatal 
disease. One hundred and fifty years ago one third 
of the people of Europe were pock-marked ; over one 
half of those who were in the blind asylums had been 
made blind by smallpox; and the deaths from the 
disease ran. up into the hundreds of thousands every 
year. It was worth taking some risk in the form of a 
mild infection to protect one's self against such a 
severe disease. Barely over a hundred years ago, an 
observant English doctor named Edward Jenner no- 
ticed that the milkmaids who milked the cows in the 
country district in which his practice lay sometimes 
caught from the udders of the cows a skin eruption 



2 4 o COMMUNITY HYGIENE 

on the hands and arms, and that after they had had 
this, they never caught smallpox. After studying 
and watching the disease for over twenty years, he 
found that the protection given by this skin erup- 
tion, called cowpox, was so certain against smallpox 
that he finally persuaded one of his patients to allow 
his little boy to be inoculated with a few drops of the 
fluid taken from this eruption. The boy developed 
a mild attack of cowpox. A few weeks later, he was 
exposed to a very severe case of smallpox, and a 
few months later was again inoculated with cowpox 
without the slightest bad effect. 

From this tiny beginning, the process spread until 
vaccination (so called from the Latin word vacca, a 
cow) spread all over the civilized world, and within 
half a century it had cut down smallpox from one of 
the commonest and most dreaded causes of death 
known to civilization to one of the rarest and least 
serious. From deaths formerly estimated at six hun- 
dred thousand a year, the total deaths in western 
Europe from smallpox now seldom reach as many 
hundreds. In some European countries in which 
everybody must be vaccinated every seven years a 
whole year frequently passes without a single death 
from this disease. 

That was the first of the preventive vaccines, long 
before we knew anything about germs. When germs 
were discovered, we set to work at once to make 
out of them a means of protection against the dis- 
eases which they caused. It was found that our body 



THE SPREAD OF DISEASE 241 

cells resist or conquer disease by (1) eating up the 
disease germs, and (2) poisoning them with anti- 
toxins. When a person becomes sick with scarlet 
fever, for instance, the body cells begin to make 
these antitoxins which finally destroy the disease 
germs. For the rest of his after life his body cells 
know how to make this antitoxin, and if any new 
scarlet- fever germs get into his body they are de- 
stroyed before they can begin to poison him. 

Vaccines work on the same principle. They pro- 
duce a very mild attack of the disease. The body 
can easily produce enough antitoxins to overcome 
this light attack. Then, having learned the trick of 
producing antitoxins for this disease, it is prepared 
ever after to deal with even the most vicious types 
of its germs and fight off a full-grown attack of the 
disease. 

We now have a number of vaccines against vari- 
ous diseases, the most useful being the typhoid vac- 
cine. This consists either of a number of dead ty- 
phoid germs killed by heat, or a smaller number 
which have been mixed with the serum from the 
blood of a patient who has recovered from typhoid 
fever (which contains antitoxins). Three injections 
of this vaccine are given with a hypodermic needle 
under the skin of the arm. These injections are 
given about ten days apart, and protect the per- 
son against typhoid fever, usually for three to six 
years and possibly for life. By such typhoid vaccine 
the cases of typhoid in the United States Army 



242 COMMUNITY HYGIENE 

have been reduced to an almost negligible propor- 
tion; and even the enormous armies in the field in 
the European war were kept nearly free from this 
most deadly disease of the camps. Other useful 
vaccines are those against blood-poisoning, erysip- 
elas, boils, certain blood diseases, cholera, and the 
plague. 

Antitoxins. In some diseases we have succeeded 
in extracting from the blood of patients or animals 
that have recovered from a disease the antitoxins 
which cure it, so that we can use these directly in the 
cure of the disease as well as in its prevention. Of 
these antitoxins the most famous and useful is the 
diphtheria antitoxin, which has robbed of most of 
its terrors one of the deadliest diseases of childhood. 
Before the use of antitoxin, the death-rate used to 
run from twenty-five to forty per cent of the chil- 
dren attacked. Now the average death-rate is less 
than ten per cent; and in cases which are recog- 
nized quickly and where the antitoxin is used early, 
scarcely five per cent prove fatal. We have also 
an antitoxin for cerebro-spinal meningitis (spotted 
fever), and one for tetanus (lockjaw). 

Insects that help to spread disease. One of the 
most valuable weapons ever put into our hands for 
the fight against disease is the discovery of the part 
played by insects in spreading it. A number of our 
most serious diseases cannot be spread through food 
or water, but must be carried directly from the blood 
of one patient into the blood of another. As human 



THE SPREAD OF DISEASE 243 

beings do not bite one another, even in the most un- 
civilized neighborhoods, the only way in which this 
transfer can be made is by some biting and blood- 
sucking insect. The vermin which infest badly kept 
houses do not travel far enough to play a prominent 
part in this respect, although they do their little 
best. One of them, the flea, is the principal carrier of 
the dreaded Black Death, or bubonic plague — not 
directly from one human being to another, but from 
a human being to a rat, and from an infected rat 
again to another human being. The louse spreads 
typhus fever, but both vermin and disease are 
practically unknown in civilized communities. The 
champion distributors of insect-borne diseases, as 
we have seen, are the mosquito and the fly. The 
mosquito is the sole means of spreading malaria and 
yellow fever, one species (Anopheles) carrying ma- 
laria, and another {Stegomyia) yellow fever. 

The fly is a good mixer. The other disease- 
spreading insect, the fly, is somewhat more difficult 
to deal with. If we do not keep him out of the house 
by screens and "swatters," we can rely on his bring- 
ing us a sample of every kind of filth in the neigh- 
borhood. 

We have seen in a previous chapter that nearly all 
the flies that come into a house are bred on the prem- 
ises ; and in many districts it is entirely for us to de- 
cide whether we will have flies about the house or 
not. In cities and thickly settled neighborhoods the 
community has to assist by passing laws forbidding 



244 COMMUNITY HYGIENE 

the accumulation of manure-heaps, garbage-heaps, 
piles of dirt, or collections of trash big enough to de- 
cay and keep moist in the center. Any warm moist 
spot of this description will be used as a nursery by 
the fly. Nearly all cities now have laws aimed to 
prevent the breeding of flies, but they are often not 
as well enforced as they should be. 

One of the most useful services children can render 
to the health of the community is to form groups and 
associations for the sanitary inspection of the neigh> 
borhood. Admirable work has been done by the Boy 
Scouts and similar organizations. Sometimes they 
cooperate with the health authorities or the police. 
The neighborhood is divided into districts, and each 
street or block or alley is assigned to one or more 
boys and girls, who patrol it every day and make a 
report to the sanitary authorities, or to the police, 
of all the garbage piles, dirt heaps, offensive and de- 
caying substances, or unwholesome manure heaps. 

At first a few property owners and householders 
will resent this method of reminding them of their 
civic duties; but if the inspecting and notifying is 
politely and tactfully done, it is not long before the 
whole neighborhood appreciates the improvement in 
looks and health conditions brought about by this 
method. Every good citizen, young or old, is re- 
sponsible not merely for passing laws, but for their 
enforcement. Merely to put a law on the statute 
books and then leave it to the regular officials to en- 
force will never produce much result. The officials 



THE SPREAD OF DISEASE 245 

have a right to demand the assistance of the com- 
munity, and it is a great help and encouragement to 
them to feel that they have its sympathy and sup- 
port in the performance of often difficult and dis- 
agreeable duties. Some one has invented a new civic 
commandment: "Thou shalt bear witness against 
thy neighbor's garbage heap." 

By such methods it is possible to make a town 
practically "flyless," and it has been repeatedly 
done. The city of Cleveland, for instance, by a cam- 
paign of education and cooperation has made the fly 
a curiosity throughout its more than half a million 
population. Civic helpfulness of this sort in which 
the boys and girls play a most important part has 
far-reaching results. 

Cats, rats, and tramps. Three other kinds of dis- 
ease-spreaders are the domestic cat, the rat, and the 
tramp. As a carrier of infections, the cat has few 
superiors. As has been shown, rats and their fleas 
are responsible for the bubonic plague, and we have 
no certainty that some day it may not get a foothold 
here, unless we destroy our rats. 

Tramps also are dangerous disease-spreaders, on 
account of their often having some infectious dis- 
ease, and of their wandering habits. It is high time 
that the community woke up to the -need of dealing 
radically with the tramp problem. They should be 
grouped in farm and industrial colonies, given good 
food and shelter and happy surroundings, made as 
nearly self-supporting as possible, and prevented 
from spreading disease and crime. 



CHAPTER XXX 

THE GREAT CAUSES OF DEATH 

Mortality statistics. For several years the Census 
Bureau at Washington has been collecting statistics 
about the causes of death over a large part of the 
country. This has been done every year, while the 
census of the population has been made every ten 
years. In many ways this registration of the number 
of deaths and their causes is more important than 
the census. The census shows us where and how 
much we are growing in numbers, how many mar- 
riages are talking place, in what kinds of business we 
engage, and many other items of interest. But it does 
not tell us what is causing people to die, where evil 
conditions exist, or what has been done or should be 
done to remedy such conditions: This can be done 
only by finding out the meaning of the mortality 
statistics and the changes in them from year to year. 

The recent reports inform us that the great causes 
of death are the following: Heart disease, tubercu- 
losis, pneumonia, kidney disease, cancer, cerebral 
hemorrhage, and the intestinal diseases of babies. 
These diseases together cause over half of all deaths. 

Heart disease. Heart disease causes the most 
deaths of them all. It is causing more deaths now 
than it did a number of years ago. Why ? Prob- 



THE GREAT CAUSES OF DEATH 247 

ably because it is seldom fatal except in old age. On 
the whole people are living longer now than they did 
then, so that more in proportion have a chance to 
die of this disease. But many kinds of heart disease 
are due to the effect of various infectious diseases, 
such as scarlet fever, diphtheria, and tonsillitis. 
These may have occurred way back in childhood, 
but they have left a lifelong effect. It is there fore very 
possible to prevent a great deal of the heart disease 
when we prevent infections. 

Tuberculosis, the Great White Plague. Tubercu- 
losis is known as "the Great White Plague," and the 
name is well deserved. Even now it kills more white 
people than does any other germ disease. It might 
be called "the Great Black Plague " as well, for it 
seems to be even more fatal for the colored people in 
this country. Only a few years ago tuberculosis 
ranked even above heart disease as an enemy. It is 
especially severe with poor people and others who 
are poorly fed and who may live under unclean con- 
ditions. It is so common that it is difficult for the 
health authorities to be as strict as they might with 
those who have it, although a great deal has been 
done to help. In this country now deaths from this 
plague are only three fourths as frequent as they 
were fifteen years ago. As people come to know more 
about how it is spread, and are willing to have as 
strict steps taken as in such diseases as diphtheria 
and smallpox, it is probable that tuberculosis will 
become just as uncommon. 



248 COMMUNITY HYGIENE 

Pneumonia. You have often heard it said that 
pneumonia is caused by a chill or great exposure to 
cold. We now know that there is very little truth in 
such statements. There are several kinds of pneu- 
monia, but all of them are caused by bacteria. Most 
of them are infectious diseases, just as much as are 
measles or typhoid fever. In certain cases it attacks 
us when we are weakened by some other disease, or 
overwork, or lack of proper food, but this is because 
there are usually germs of a comparatively mild 
form of pneumonia in our throats which do not harm 
us as long as we are strong and well. Most cases, 
however, are caught from some one else who has the 
disease. It has been found that much of the pneu- 
monia can be prevented by a vaccine which is some- 
thing like that used in preventing typhoid fever, and 
such vaccination has been effective among the sol- 
diers in some of the camps where pneumonia was 
especially apt to occur. This method will probably 
be used much more generally as time goes on. Then, 
of course, if the same sort of care is taken of people 
with pneumonia, as of those who have other infec- 
tions, it will have much less chance to spread. It 
was only a very few years ago that we came to know 
that it was "catching," but, even in the short time 
since, it has become much less a cause of death. 

Kidney disease. While we are not sure that all 
kidney disease is caused by germs, we know that 
much of it is; therefore can be prevented. When 
doctors study the cases, they seem to be much more 



THE GREAT CAUSES OF DEATH 249 

frequent among those who have had infectious dis- 
eases when they were young, especially scarlet fever. 
So even in this disease right methods of living and 
guarding against infection will result in much less of 
it. 

Cancer. Despite much scientific research, cancer 
still baffles mankind. Yet we do know that it is kill- 
ing more people every year. The reason for this may 
be the same as that which we have given for the in- 
crease in deaths from heart disease — it is a disease 
of older people. We also know that a very large pro- 
portion of the deaths from it can be prevented; 
but in order to do this people must learn one thing. 
As soon as they find that they have a tumor, or 
swelling, or a sore that does not readily heal, they 
must go to a good surgeon, and be prepared to have 
it removed. The idea of an operation frightens some, 
but the knowledge that without it an incurable 
cancer may develop should lead any one to overcome 
fear. If it is done early, the operation is usually very 
simple, and in a few days the patient is feeling as 
well as ever. 

Cerebral hemorrhage. This is often called apo- 
plexy. It is due to a weak blood vessel in the brain, 
and is more apt to be a disease of quite old age. 
There are certain germ diseases, however, which are 
known to make it occur before it would otherwise. 

Intestinal diseases of babies. Practically all 
deaths from this cause are a disgrace to civiliza- 
tion, and are caused by germs in milk or water or on 



250 COMMUNITY HYGIENE 

the food. This is being rapidly realized, and there is 
now hardly half as much as there was at the begin- 
ning of the century. It is to be hoped in the future 
such diseases will be unknown. They can be, if 
mothers will learn to do all that is now known in 
regard to preventing them. 

Making a longer-lived and happier race. You will 
see from what has been said in this chapter that a 
great part of the deaths from all these great causes 
can be prevented. If we add to these the great num- 
ber of other germ diseases and the preventable acci- 
dents which kill so many people, we can hope that in 
the future, when every one realizes these evils and 
takes a part in helping to stamp them out, almost 
every one will be able to live to a healthy, conse- 
quently a happy, old age. 



CHAPTER XXXI 

INDUSTRIAL HYGIENE 

Making the factory fit the child. Fifty years ago 
it was taken as a matter of course that a shop, work- 
room, or factory could be a dirty, half-lighted, un- 
ventilated place. Dirt and grime were looked upon 
as a sign of industry. Both workmen and foreman 
were supposed to be superior to such affectations as 
keeping themselves, their benches, or their shop 
clean and tidy. The crude old proverb, "Where 
there's muck, there's money," was the motto of the 
day. Workrooms and shops were put in the cellar, 
the attic, tumbledown sheds, or old barns. If the 
place was n't dirty to begin with, it would soon be- 
come so. 

Gradually, however, it began to dawn upon em- 
ployers and workmen that if good work of any kind 
were to be done, it must be done in good light. If 
fine and delicate work were to be turned out, benches 
and material must be kept clean and free from dirt 
and grit. When machinery and fine tools began to 
be used, it was found that they wore out much 
faster if they were allowed to get dirty, rusty, 
clogged, and covered with dust. 

Then it was noticed that whatever made dirt in a 
shop was either waste of material which could be 



252 COMMUNITY HYGIENE 

saved and used, or waste of fuel. Workshops began 
to be well lighted, well kept, and cleanly. 

Last of all, — and not until within the last fifteen 
or twenty years, — it occurred to employers that 
the human machines which they were using would 
do better work and last longer if they were given 
plenty of light, plenty of air, and comfortable tem- 
perature, as well as being well fed, well housed, and 
not worked more than a reasonable number of hours 
a day. Even machinery must be given regular inter- 
vals of rest. It is now considered good business to 
make workshops as light, as well ventilated, as free 
from dust and poisonous fumes, and as well supplied 
with everything that promotes and protects the 
health of the workmen and workwomen, as it is 
reasonably possible to make them. 

This is particularly true of shops, factories, and 
other establishments where children are employed. 
Children have less strength and less muscular en- 
durance, and are far less able to resist the effects of 
bad air, overheating, poisonous dusts or smells, and 
confining and cramping occupations. It is not too 
much to say that to-day the standard of health offi- 
cers, of intelligent business men, and of labor unions 
alike is to make shops and factories places which 
will actually protect and promote the health of those 
who work in them, instead of disease-breeders and 
death-traps. 

Choosing a suitable life-work. It is very im- 
portant that each child should choose work for 




Courtesy Nat. Child Labor Com., N.T. 

FACTORIES THAT MAKE BAD CITIZENS 



254 COMMUNITY HYGIENE 

which he is physically, mentally, and temperament- 
ally best fitted. It was formerly supposed that most 
children would make a fair success at almost any or- 
dinary occupation, if they were sound mentally and 
bodily, and had a fair amount of time to learn the 
trade. Under this plan a general scheme of educa- 
tion was devised, and every child was compelled to 
take exactly the same training up to fourteen or 
sixteen years of age. 

Now we know that we begin to show differences, 
fitting us for particular occupations and unfitting 
us for others, as early as the tenth or twelfth year. 
The widespread introduction into schools of man- 
ual-training shops and various forms of technical 
education is the result. The aim is not so much to 
teach each pupil some trade as to give him a chance 
to try his hand at a number of different trades in 
order to get some idea of which one will prove best 
for his life-work. 

The hours of work and fatigue. One of the first 
things discovered when we began to study the hu- 
man side of industry was that too long hours of 
work are a mistake from an economic point of view. 
When the waste products produced by muscular 
and mental work — known as the fatigue poisons — 
gather in the blood to a certain amount, the quality 
of the employee's work begins to run down rapidly, 
and it becomes necessary for him to rest until the 
blood can get rid of these poisons. If this is not 
done, one or all of three things happens: (i) The 



INDUSTRIAL HYGIENE 255 

workman begins to make mistakes in his work, 
which cost more than the results he is producing; 

(2) he begins to be slow and careless in his move- 
ments and is likely to get caught in the machinery; 

(3) the poisons, continuing to gather in his blood, 
attack the arteries and cause them to decay and 
stiffen, and the man is finally made unable to work. 

The list of accidents in a factory proves this. Acci- 
dents are fewest in the morning, at the beginning of 
the day, although some are due to various difficulties 
in starting the machinery and getting under way. 
Then they increase steadily until the noon hour. 
After the noon hour there are fewer accidents, al- 
though not quite as few as in the morning, and from 
that time they increase steadily until the hour for 
closing, the largest number occurring always be- 
tween five and six o'clock in the afternoon. In other 
words, the more tired the workmen are, the more 
likely they are to suffer serious accidents. 

From twelve hours the day's work was shortened 
to eleven, then to ten, where it hung for a good many 
years, then to nine ; while now the standard regarded 
as best for the efficiency of the factory and the health 
and comfort of the working-people is eight hours a 
day, with a half-holiday on Saturday. So much has 
the shortening of the hours improved the health, the 
vigor, and the mental alertness of the workmen, that 
even with the same machinery factories now turn 
out far more work in the eight-hour day per work- 
man than they used to do when they worked for 



256 COMMUNITY HYGIENE 

twelve hours a day. Not only have wages not fallen 
with the shortening of the day, but they have stead- 
ily risen, with the net result that the men are working 
shorter hours, and the employers are paying higher 
wages, and getting a larger output per workman than 
ever before in the history of the world. 

Ventilation and lighting of the shop. Plenty of 
good light is so necessary if good work is to be done 
and machinery is to be kept working well that our fac- 
tories and workshops are now coming to be among 
the best-built and best-lighted buildings that we 
construct. Since we have learned how to build with 
concrete and steel and glass, the walls of the modern 
up-to-date factory are practically all windows, and 
they are more brightly lighted from every side than 
even the best of private houses or public buildings. 

It has also been found that the expense of running, 
the danger from fire, and the difficulties in moving 
goods about from one department to another, in 
keeping materials clean, and in ventilating are so 
much increased by piling one story upon another 
that the best factories now are tending toward one- 
story or two-story buildings, with skylights in the 
roof, as well as glass walls. This requires a much 
larger area of ground on which to build the plant; 
and for this reason our factories which, thirty years 
ago, were crowding into our cities, are now leaving 
them and moving into thinly settled suburbs or into 
the open country. Transportation of raw materials 
and of finished products has become so much cheaper 



INDUSTRIAL HYGIENE 



257 



and swifter that factories can establish themselves 
where they please. The advantages of one-story or 
two-story buildings, with electric tramways con- 
necting all departments, freedom from dirt and dust, 
good light, good ventilation, and better living and 
housing conditions for their employees, make the 
suburb, the village, or the country far preferable to 
the great city. Light and air go hand in hand with 
health and good work. 

Since proper smoke-consuming methods have be- 








THE RIGHT KIND OF WORKROOM 

Notice the broad aisles, the big windows, the well-shaded electric lights, the clean 
aprons, the white walls, and the general look of neatness and cleanliness. The 
modern manufacturer knows that these things make the workers happy and well 
and increase their output. 



258 COMMUNITY HYGIENE 

come common, the clouds of smoke and soot which 
used to be considered part of a factory town have 
disappeared. Moreover, our factories now are built 
of glass and iron and steel, set in ample, park-like 
grounds, with the buildings surrounded by grass, 
shrubs, and flowers. They are being made as attrac- 
tive as a college campus or city park. Every scrap of 
carbon and soot which blackens the skies and makes 
our houses dingy is so much good fuel gone to waste. 
Manufacturing towns may be made as spotless, 
wholesome, and beautiful as the prettiest residence 
village, not only without loss, but with profit to 
everybody concerned. 

Guarding against accidents. The best protection 
against accidents is reasonable working hours, good 
ventilation to prevent fatigue, and good lighting to 
prevent mistakes from inability to see clearly. Next 
after this come proper guards for the dangerous parts 
of machinery, such as cogs, gears, and belts. The 
number of workers killed in our factories every year 
is enormous. The estimates run anywhere from 
twenty to thirty thousand ; and a large percentage of 
these lives could be saved by proper equipment and 
care. Almost every factory where healthful hours of 
work have been instituted, good light and air pro- 
vided, and proper guards installed over machinery, 
has shown a decrease in the number of accidents. In 
some cases the decrease has amounted to a half, or 
even three quarters of the former number. The 
proper covering of machinery also protects it against 



INDUSTRIAL HYGIENE 259 

dust, dirt, and accidents, so that it keeps in better 
condition and lasts longer. Again, life-saving and 
health protection go hand in hand with good busi- 
ness practice. 

Guarding against fire. The most dreaded acci- 
dent of all in factories is fire; and all states and 
cities now insist that factories where many employ- 
ees work shall be so built, and so provided with stair- 
ways, fire-escapes, fire-hose, and sprinkler systems as 
to reduce the fire-risk to a minimum. Many of the 
older factories, which were started in a shed and ex- 
panded by the addition of other sheds as the business 
grew, were the deadliest of fire-traps; and a certain 
class of ignorant, greedy, short-sighted manufac- 
turers, until they are forced by law to improve their 
plant, will continue to keep buildings of this kind, or 
to crowd workers into rooms where there are no ade- 
quate stairs and fire-escapes. 

But the better and more intelligent manufacturers 
have discovered that good protection against fire is 
one of the best possible investments. If the workers 
know their factory is of fireproof construction with 
plenty of stairs and fire-escapes, they will stay to 
fight a fire .instead of making a panic-stricken rush 
for the stairs the moment the first burst of flame or 
smell of smoke is noticed. The new methods of con- 
struction with steel and cement and glass lower the 
fire-risk greatly; and when the buildings are only one 
or two stories high, they are even safer. In fact, 
a thoroughly up-to-date, well-planned, modern fac- 



2 6o COMMUNITY HYGIENE 

tory building is now safer from fire than an average 
private home. 

Dangerous fumes, dusts, and lints. Another 
serious danger to the health of working-people is 
that the goods manufactured in many industries 
give off dangerous or poisonous fumes, or clouds of 
steam, or choking dust, or fill the air with a fine lint 
which blocks up and irritates the nose and throat. 
Some of these fumes are poisonous, such as the fumes 
of certain kinds of phosphorus used in making some 
matches, or of lead in the manufacture of paints, or 
the glazing of certain kinds of pottery. Poisonous 
fumes first attracted our attention to the diseases 
known as diseases of occupation. When the question 
was first studied, it was found that thousands of 
workers every year were being poisoned by lead in 
the potteries and paint factories and by phosphorus 
in the match factories. 

The lead fumes produced violent attacks of pain 
in the stomach and intestines, known as lead colic, 
followed by paralysis of the nerves, particularly of 
the hands and wrists, but finally extending to all the 
nerves of the body, including the optic nerve, and 
producing blindness. The commonest paralysis, how- 
ever, was of the muscles of the forearm so that the 
hands could no longer be lifted at the wrists, but 
hung down limp. This was known as wrist drop. 

Phosphorus poisoning attacked the teeth and jaws 
of workers, producing decay of the bones of the jaw 
and face, known in the mills as phossyjaw. When it 



INDUSTRIAL HYGIENE 261 

was first attempted to pass laws to avoid this hor- 
rible poisoning, some manufacturers bitterly resisted 
them, declaring that they were necessary risks of the 
trade, and if the employees did not care to run these 
risks they could seek another job. However, the 
fumes of phosphorus could attack the jaw only 
through the ulceration of the gums surrounding de- 
caying teeth; and when the manufacturers were 
compelled to supply dentists and have their employ- 
ees' teeth examined and repaired at regular intervals, 
the amount of "phossy jaw" was lessened. A little 
later it was found that the use of red phosphorus in 
place of yellow would do away with the fumes alto- 
gether, and most matches are now made with red 
phosphorus, so that "phossy jaw" is rare. 

In the case of lead poisoning, it was found that the 
greater part of the poison was carried into the sys- 
tem of the workers, not in fumes in the air, as had 
been supposed, but in the food eaten at lunch- time 
in the factory. Lunches were eaten without the lead 
being thoroughly washed and scrubbed off the hands 
of the employees. When wash-rooms and lunch- 
rooms were provided, lead poisoning was cut down 
to less than one fifth of its former proportions. By 
forbidding its use as a glaze in potteries, and com- 
pelling the manufacturers to seek a non-poisonous 
substitute, it has been largely brought under control 
in this industry. Nearly the same results have been 
attained in the case of most of the other poisonous 
fumes or dangerous dusts and lints, 



262 



COMMUNITY HYGIENE 




THE RIGHT KIND OF WASH-ROOM 

This is a factory wash-room. Notice the cement floor, the clean basins, the hot and 
cold faucets, the individual towels, and the shower baths. Do you approve of the 
hairbrush and comb ? What do you think about the drinking-cups on the shelf ? 



Where gases are given off in certain stages of man- 
ufacture, hoods are provided to cover the tables or 
forges or retorts causing the fumes, and by means 
of a fan these fumes are sucked up into chimneys 
and discharged into the open air. In other cases the 
fitting of proper screens, or the wearing of masks by 
the workers, prevents most of the danger. Lints and 
fine dusts can be made less harmful by keeping either 
the fabric or the air of the room charged with a fair 
amount of moisture. In fact, there is scarcely a dirt 



INDUSTRIAL HYGIENE 263 

or a dust or a gas which cannot be dealt with in such 
a way as to make the air of the room fairly whole- 
some and safe to breathe. The improvement in the 
comfort of work, the quality of the goods turned out, 
and the lessening of accidents is so great that em- 
ployers would not do without them when once they 
see the results of their use. 

Lunch-rooms, rest-rooms, and wash-rooms. Many 
of the employees in factories live so far away that 
they must bring their lunches with them, and it 
is found that eating these lunches with unwashed 
hands in the back yard or the workrooms is one of 
the commonest ways of making them sick. The 
health authorities suggested that special lunch- 
rooms should be provided in factories. This pre- 
vented so much sickness and improved the health 
and comfort of the employees so greatly that most 
of our factory laws now require that a certain num- 
ber of lunch-rooms, and a certain number of wash- 
basins with hot and cold water and soap, shall be 
provided for every fifty to one hundred employees 
engaged in each factory. 

In addition to the protection against disease and 
the loss of time through illness, the cleanliness 
and comfort given working-people by wash-rooms, 
toilets, and lunch-rooms improves the quality of 
their work and keeps the materials cleaner. There- 
fore, a modern, progressive factory equips itself with 
attractive lunch-rooms and toilet-rooms, with mod- 
ern conveniences, provides rest-rooms, and often 



264 



COMMUNITY HYGIENE 



reading-rooms, for the use of the employees during 
the noon hour. These latter are often kept open after 
closing time for those who wish to read magazines or 
draw books to read at home. Some great business 
organizations and many department stores employ- 
ing thousands of young people have actually pro- 
vided concert halls and dancing-floors for use in the 
noon hour. Many of the leading manufacturers 
provide athletic fields, and not a few of them pro- 
vide tracts of land which can be divided into gardens 
and used by the children of their employees. 

These far-sighted, broad-minded, successful em- 
ployers assure you that this is simply good business. 




HOW A FACTORY FEEDS ITS MEN 



This modern factory has kitchens and dining-rooms where good wholesome food is 
furnished at cost to its workers. Would you rather eat here or bring a cold lunch in 
a pail ? Which do you think is better for the workers ? 




Courtesy Town Roo 

FACTORY DOCTOR AND NURSE AT WORK 
Accidents and sudden illnesses are treated in the emergency room. 



266 COMMUNITY HYGIENE 

It attracts to them the most intelligent class of labor; 
it lessens loss of time through illness of skilled work- 
ers ; it increases the working power of employees by 
making them healthy, happy, contented, and inter- 
ested in their work, and it gives employees an in- 
terest in the success of the business and makes them 
willing to do everything they can to increase its out- 
put and improve the quality of the goods. 

The factory physician and nurse. One of the 
most helpful agencies in industrial hygiene has been 
the factory physician and the factory nurse. These 
were first provided many years ago mainly for the 
purpose of giving surgical attention to such serious 
accidents as might occur in the factory. Then their 
services were extended to all sorts of cases and all 
kinds of illness occurring while the employees were 
in the factory, and finally led to watching the sani- 
tary conditions of the rooms and machinery, the 
physical conditions of the workers themselves, and 
the health of their homes. 

Among most of the European nations every one 
who applies for work in a factory or business is given 
a careful physical examination by the factory phy- 
sician. If he has any serious disease he is promptly 
referred to a government hospital or sanitarium, 
where he is taken care of without charge until he is 
cured, and his family is supported in the mean time. 
If there is something about his health which makes 
it dangerous for him to engage in this particular 
trade, he is advised to try some other industry. If 



INDUSTRIAL HYGIENE 267 

he is considered suitable for the work, he is assigned 
to the particular branch of the work for which his 
previous training and physical condition seem best 
to adapt him. 

The largest factories now have a nurse for each 
two or three hundred employees, and a doctor for 
each thousand. Both doctor and nurse are con- 
stantly on duty at the factory, with a dispensary, 
small surgery, and usually one or two beds where 
cases of sudden illness can be cared for until removed 
to their homes. Every employee who seems ill on 
coming to work, or who is noticed by the foreman or 
nurse as looking tired at his work, is promptly sent 
down to the doctor's office for examination. Every 
accident, no matter how slight, — a cinder in the eye, 
a bad scratch on the hand, a crushed finger-nail 
or toe-nail, — is at once treated. In factories which 
have adopted this plan, the number of days' time 
lost from illness in the working force has often been 
cut down to one half or even one third of its former 
amount. 



CHAPTER XXXII 

TRAFFIC, SMOKE, AND LIGHTING 

Safety first. Up to fifty or sixty years ago, roads 
and streets, whether in town or country, were open, 
leisurely, friendly places, where one could stroll up 
and down, or walk, or even sit in the gutter and play 
with comparative safety. But when thousands of 
people began to live upon a few acres, and poured 
down a single street to reach their work every morn- 
ing and back again in the evening, while their sup- 
plies and letters and shipments of goods rolled 
through it in a steady stream all day long, a street 
became a place of danger. 

In all our greatest cities to-day, on both sides of 
the Atlantic, the roaring avalanche of traffic which 
pours constantly down the trunk-streets has become 
so dense that special traffic police have been trained 
to handle the crowds of passengers and vehicles. At 
the intersections of the principal streets every thirty 
to sixty seconds the traffic policeman lifts a gloved 
hand, dams up the stream of traffic first in one direc- 
tion, then in the other, until the waiting foot passen- 
gers can stream across the street. By this careful 
policing, the busiest streets of our largest cities have 
become actually the safest. It is in the smaller and 
less frequented streets, where there is no policeman 



TRAFFIC, SMOKE, AND LIGHTING 269 

to guard foot passengers or to insist that the speed 
limit be observed, that there is the greatest danger 
of street accidents. 

While the chief responsibility rests upon the driver 
of the vehicle, whether automobile, wagon, carriage, 
or truck, and the law makes it clearly his duty to see 
that he does not run down and injure foot passen- 
gers, however careless or stupid they may be, yet a 
considerable percentage of accidents is due to care- 
lessness, ignorance, or recklessness on the part of foot 
passengers. This danger, although greatest in cities, 
is by no means confined to them. Ever since the in- 
troduction of the motor-car country roads have be- 
come places of serious danger, so that it is well worth 
while to develop a safety code for crossing streets 
and much-traveled roads in both country and city. 
In any case, it should be made a matter of second 
nature never to cross any street without first looking 
carefully in both directions. In the days of slow- 
moving, horse-drawn wagons or drays, you could get 
across the street before anything which was fifteen 
or twenty yards away could run you down. But now 
a fast automobile, which is three blocks up the street 
when you step off the sidewalk, has time to hit you 
before you can cross. When you see an automobile 
or a trolley car coming, never undertake to run 
across the street in the foolish hope of "beating it." 
Fully two thirds of the serious accidents due to the 
fault of foot passengers occur from this senseless 
habit, especially when crossing a city street where 



270 COMMUNITY HYGIENE 

there are two streams of traffic coming in opposite 
directions. A foot passenger sees a wagon coming 
from his left, makes a rush to get across in front of it, 
and lands squarely in front of another vehicle com- 
ing from the opposite direction. Never on any ac- 
count hurry across a street, or put your head down 
and make a dash for the other side. 

Everybody looks both ways before he crosses the 
street, or at least imagines that he does ; but another 
precaution not so generally recognized is that of lis- 
tening carefully. The chief reason why we have two 
ears is that we may be able to judge of the direction 
from which sounds are coming. When you have once 
satisfied yourself by a glance of the position of the 
nearest wagon or automobile in each direction, and 
have started across, your ears will warn you if either 
of the vehicles which you have noticed quickens its 
pace, or if any other swiftly moving vehicle runs into 
the danger zone. In fact, the safest way to cross a 
busy street is to choose your time carefully, and 
then, looking steadily ahead, walk straight forward, 
listening with both ears. Glancing too far to one 
side or the other after you have started to cross is 
almost as dangerous as putting your head down and 
rushing. Your ears, if in proper condition, will warn 
you of any danger in plenty of time to jump or turn 
your head. If you move steadily and quietly, with 
all your wits about you, looking as if you knew ex- 
actly where you were going, almost any driver or 
chauffeur will be able to avoid you. But if you start 



TRAFFIC, SMOKE, AND LIGHTING 271 

with a wild rush, lose your courage halfway across, 
dart back again, jump sidewise, and start ahead 
again, the most skillful and careful driver may run 
over you in spite of himself. 

Street-cars and omnibuses. A special code of 
safety has grown up for street-cars and omnibuses. 
These vehicles are limited to a certain route and stop 
at regular intervals. On this account they can be 
more easily avoided than free vehicles ranging over 
the pavement. A few simple rules should be care- 
fully observed : — 

First, never on any account stop upon a street-car 
track, even though the car is nowhere in sight. 
Never play on it. 

Second, remember if you are two feet or more 
away from the track, you are as safe from the on- 
coming car as if you were on the sidewalk. 

Third, remember whether trolley-cars stop on the 
near or the far side of the street, and guide yourself 
accordingly in crossing in front of them. Most city 
ordinances require street-cars to stop on the near 
side of cross-streets, because that gives both foot 
passengers and vehicles a safe opportunity to cross 
that street while the car is stopped. When pave- 
ments were poor and streets were muddy, this near 
stop landed the passengers twenty or thirty feet away 
from the crossing. But with the introduction of well- 
kept pavements, this objection has disappeared. 

Fourth, bear in mind always to wait until a car 
stops before stepping off the platform, to step off 



272 COMMUNITY HYGIENE 

facing toward the front of the car, — ■ in the direction 
in which it. is moving, — and to hold on firmly with 
the hand nearest the car until the foot strikes the 
ground. It is also well to look in both directions, es- 
pecially behind the car, to see that no other vehicle 
is coming rapidly in the same direction so as to over- 
take the car and put you in risk of being run over 
when you step down on the street. This is a common 
cause of serious accidents, and many cities compel 
all vehicles to slow down or stop when a car is stop- 
ping ahead of them, or to drive wide of it so as not to 
endanger alighting passengers. Unfortunately, this 
law is not always observed. It is also well to insist 
that the conductor bring the car to an absolute stop 
before you get off at your crossing. A slight disturb- 
ance of your balance may cause a dangerous fall, es- 
pecially upon the hard pavement. The spill is so 
sudden that usually one has no time to throw out a 
hand to save one's self, and is likely to strike with 
full force on the shoulder, back, or head. A fall from 
shoulder height to the pavement is quite sufficient 
to fracture the skull. It is also dangerous to attempt 
to get on cars while they are in motion, because if 
you do not succeed in reaching the step at once, you 
are likely to be dragged by your hands and proba- 
bly jerked under the rear wheel of the car. 

Rules of the road. If you ever drive a horse or a 
motor-car, it is most important to observe strictly 
the rules which have been laid down as a driving 
code. You must know all about the proper side of 



• K\— IHKl—t, 








jWy" 


• 


ylH HH| 






--":■>%;. Vo, 


■ 

■ 


;■•■' • - I V 








Courtesy N. J. Public Safety Commission 

DON'T PLAY ON CAR-TRACKS 

Cars cannot always stop quickly, and a lost arm or leg may be the price of a few 
minutes' thoughtless play. 



274 COMMUNITY HYGIENE 

the road, stopping, turning, and slowing down. In 
most civilized countries, except England and Russia, 
it has become first an unwritten and then a written 
law that all drivers of moving vehicles shall keep to 
the right when meeting one another; and must drive 
down the right-hand half of the roadway in crowded 
streets. In England and Russia it is the rule to turn 
to the left and to keep to the left-hand side of 
the roadway. Nobody knows why either rule was 
adopted in preference to the other. A strict observ- 
ance of this rule makes it not only much safer for 
vehicles, but also for foot passengers. It is also re- 
quired that when a driver is going to slow down or 
stop at a house or shop, he shall throw up his right 
hand with the fingers extended so as to warn those 
coming up behind him. The same warning is re- 
quired in cities when he is about to turn a corner and 
drive into a cross-street. 

It is probably only a question of time until most 
of our heavy hauling traffic will be put underground 
or in viaducts below the street level. Much of the 
heaviest traffic is now handled between ten at night 
and six in the morning. Automobiles in the future 
probably will have special roadways of their own, as 
railroads now have, and will be compelled to keep to 
them for all long journeys and for all speeds above 
seven or eight miles an hour. To-day foot passen- 
gers, who comprise at least nine tenths of the com- 
munity, have been almost deprived of all rights in 
the streets beyond the sidewalks. 



TRAFFIC, SMOKE, AND LIGHTING 275 

Street-lighting and health. The habit of lighting 
city streets was established to enable people to see 
their way about at night without stumbling over 
things or running into other persons. Good lighting 
also rendered streets pleasanter to live on. Still, 
people grumbled about the expense until it was dis- 
covered that the well-lighted streets were not only 
safer from accident and pleasanter, but also robbery, 
street rows, mischievous destruction of property, and 
crime of all sorts became very much less common. 
Just as it was found that it was cheaper to leave 
lights burning all night in a store or bank than to em- 
ploy bolts, shutters, and watchmen, and that lights 
protected property from burglars and petty thieves 
much more effectively, so it was found that good 
lighting of a district greatly lessened crime, espe- 
cially when extended to the city streets and alleys. 
It is said that ten street-lamps equal one policeman 
for the protection of property and the prevention of 
disorder. 

Well-lighted streets were also found to be a pro- 
tection to health in several different ways, some of 
them quite unexpected. Light put a stop to the in- 
sanitary practice of throwing garbage, waste ma- 
terial, broken crockery, ashes, dead cats, and other 
refuse into the streets under cover of darkness. 
Even after it had come to be considered bad form to 
throw waste and rubbish out in front of your own 
house, it still remained a common habit to carry 
them to the back of the lot or round the corner into 



276 COMMUNITY HYGIENE 

the nearest dark side street or alley and there dis- 
pose of them. 

Another way in which plenty of street light pro- 
tected health was by encouraging people to leave 
their windows open at night. Although part of the 
old dislike of leaving windows open after dark was 
the fear of drafts and cold, a considerable part of it 
was dread of burglars. In addition to this, lighting 
of all sorts is an enemy of disease germs and decay, 
for, as we have already seen, a natural antagonism 
exists between light and dirt. No street or room 
which is not well lighted has a chance of being kept 
decently clean. 

The smoke nuisance and health. Though most 
of our artificial lighting is done at night, there are 
conditions in certain parts of our great cities which 
frequently make it necessary to illuminate buildings 
and light street-tamps during daylight hours. These 
are the clouds and fogs due to coal smoke and soot 
in the air. It was at first thought that these im- 
mense clouds of smoke and soot produced their great- 
est damage by inhalation into human throats and 
noses and lungs. 

Curiously enough, it has been proved that al- 
though smoke and smoke fog increase the liability of 
city people to consumption, the worst effect upon 
health is produced by the consequent cutting off of 
sunlight. Observations by the Weather Bureau show 
that in the winter months the amount of sunshine 
enjoyed by the downtown parts of some of our large 



TRAFFIC, SMOKE, AND LIGHTING 277 



cities is less than half that of the open country ; and 
as this is often little enough in winter, it is a serious 
loss. Every siege of the famous London fog lasting 
two days or more is invariably followed by a distinct 

rise in the rate of 
deaths from all 
causes, particularly 
among the old and 
enfeebled, or those 
already in a late 
stage of some seri- 
ous chronic disease. 
The depression of 
vitality due to the 
cutting-off of the 
sunlight is just 
enough to turn the 
scale in these cases. 
The amount of 
soot thrown into 
the air, as shown 
by spreading sheets 
upon the roofs of 
houses or in vacant 
lots in the down- 
town parts of cities 
and measuring the 

THE RESULT OF SLIPPING BETWEEN , , . , r . , 

CARS thickness 01 the 

This boy worked in a Pennsylvania coal mine, layer OI grime Cie- 
and got his leg crushed between two cars. But r . ric1 > Pir | , mnn th&m 
a street-car can do it just as surely. pOSlteQ Upon tnem 




278 COMMUNITY HYGIENE 

in a week or month, is appalling. It reaches the 
enormous amount of from two to seven tons to 
the acre! The thought of living and breathing and 
eating and sleeping constantly in such an atmos- 
phere makes us shudder. When we add to this in- 
terference with health the annoyance of the griming 
and smearing of buildings, the coating of sidewalks, 
the blackening of curtains, carpets, clothing, and all 
delicate fabrics, and above all the obstacle this rain 
of soot offers to keeping our windows open, it is clear 
why the problem of checking the smoke nuisance has 
been taken up so energetically by health officials. 
Like most improvements, the prevention of smoke 
is expensive at first, but it pays in the long run. It 
distinctly lowers the death-rate and the disease-rate 
of the city, makes life far more comfortable and 
enjoyable, and restores the possibility of beauty to 
city streets and houses. Moreover, every particle of 
soot in the air means so much good fuel gone to 
waste. All engines and furnaces should be equipped 
with smoke-consumers. These are most commonly 
operated by driving the smoke as it first comes from 
the furnace through a return flue back to the fire 
grate, where it goes through the hottest part of the 
fire again, this performance being repeated as often 
as is necessary to rid the smoke of all its combustible 
carbon particles. By this process a chimney of a 
great furnace or factory may be made to give off 
practically no visible smoke. 



CHAPTER XXXIII 

HOW CHILDREN CAN HELP THEIR COMMUNITY 

The best thing children can do. As we have seen 
there are many ways in which the citizens of a com- 
munity can help it to keep clean, healthful, and beau- 
tiful ; and every one of the things they do for the sake 
of the community will benefit them personally al- 
most as much as it benefits the town or city. 

Of course, the people who can help the commun- 
ity most are the town or city officials — • the mayor, 
the aldermen, the board of health, the city physi- 
cian, and all the other people who see that our city 
or town is well paved, well lighted, and supplied with 
good water and sewer systems; that our garbage is 
collected, our air is kept free from smoke, and our 
lives and property are protected. When we are 
grown up, we can help our community by voting 
for intelligent and good men who will fill their offices 
in such a way that all these things are supplied to the 
community. Still, we do not have to wait until we 
are grown up to help our community. There are a 
great many things that can be done by children — ■ 
even very little children — in the home, in the 
school, and in the city or town. 

The biggest and best thing that we can do is to 
keep healthy and vigorous ourselves. We are going 



280 COMMUNITY HYGIENE 

to be citizens of our community some day, and we 
want to be the best kind of citizens. We must eat 
plenty of good food, play at least two, or, better, 
four, hours every day in the open air, get plenty of 
sleep, keep our bedroom windows open, and see that 
our hands, faces, and clothes are reasonably clean. 

Keeping ourselves clean is really the beginning of 
keeping our community healthy. A good example 
is as "catching" as measles. If we look clean and 
fresh and wholesome ourselves, we will make every- 
body else want to have himself, his house and garden 
and street look clean, too. Sometimes it seems hard 
to wash, especially if our hands are chapped, and the 
soap makes our eyes smart when it gets into them, 
and the towel is rough, and the water is cold. But if 
we will only keep on doing it for a few months for 
the sake of looking well, we will find that it feels so 
pleasant to be clean that we actually enjoy it. We 
will be uncomfortable if we do not get our morning 
bath, or if we happen to omit brushing our teeth, or 
if we cannot wash our hands before a meal. 

If you keep your face and body clean, you will 
soon want to keep your clothes fresh and clean to 
match, and you will be surprised how particular you 
will be about clean shirts and collars. Of course, if 
your hands are grubby and your face grimy, and you 
can't tell what color your skin is for the dirt, you 
won't care what kind of shirt you have on. 

Keeping the house healthful. If you are clean 
yourself, you will want to live in a clean and orderly 



HOW CHILDREN CAN HELP 281 

house. Of course, you had little to do with the build- 
ing and planning of it, or the arrangement of its 
doors and windows, or the size of its rooms, or the 
way it stands on the lot. Still, it is n't altogether the 
way a house is built that makes it healthful or un- 
healthful. It is largely the way it is lived in ; and the 
children of a house have a great deal to do with the 
way it is lived in and the condition in which it is 
kept. 

First, you can keep the windows of your own room 
open, and when you notice that the air of any other 
room is stuffy and hard to breathe, you can ask your 
mother or father if you may not open the window a 
little while. You can keep the outside doors shut as 
you run in and out, and always shut the screen door 
to keep out flies and mosquitoes. You can remember 
that there is a thing called a doormat laid in front of 
the door on which children can rub off the mud and 
dirt from their shoes instead of tracking it into the 
house to dry and fill the noses and lungs of the fam- 
ily with irritating and unhealthful dust. All these 
things will keep the air of the house pure. 

Second, you can keep your own things in order. 
Perhaps you don't exactly see how this can help any- 
body to be healthy. But an orderly house is nearly 
always a healthful house, and no house can be or- 
derly unless all the people in it take care of their 
things. If you keep your books and papers and toys 
in the playroom, or in your special place in the liv- 
ing-room, and if you do at least the most "littery" 



282 COMMUNITY HYGIENE 

part of your whittling and carpentering in the wood- 
shed or barn or workshop, you will not only save 
your mother a great deal of work, but you will make 
the house much more pleasant and wholesome. 

Third, you can keep the bathroom tidy. If you 
will wash your face and hands in the bowl, instead 
of on the towel ; if you are always careful to pull the 
plug out of the washbowl or bathtub and rinse them 
with clean water after you are through washing; if 
you will remember not to walk over the bath-mat 
with your dirty shoes; and if you are careful to keep 
your toothbrush, toothpaste, and soap always clean 
and neat, you will do a good deal to help keep the 
bathroom clean and wholesome. When you have a 
cold, you should wash in a separate basin, so as not 
to infect the other members of the family. 

Fourth, you can keep the yard clean. If your 
back yard is n't as clean and orderly as it really 
ought to be, a Saturday afternoon clean-up and bon- 
fire is not only good fun, but good community hy- 
giene. Get your brothers and sisters to help you, and 
ask father or big brother to come home early and 
help you light the bonfire. Mother will be glad to 
have you do it, but of course you must ask her first. 

After the yard has been cleaned up, you can keep 
it clean with very little difficulty. If you see any 
dirt or rubbish or trash lying about the garden, or 
the lot, or the barn, take a stick or a barn fork, pick 
it up, and throw it into the garbage-can, or on the 
manure-heap, or into the rubbish-furnace if you have 





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284 COMMUNITY HYGIENE 

one. A very little trouble of this sort once or twice 
a day, or even two or three times a week, will make 
all the difference between a dirty, untidy, unwhole- 
some yard and a clean, attractive, wholesome one 
where everybody likes to come and play. 

If you help mother with the dishes, you can do a 
good deal to help keep the kitchen wholesome. In 
chapter iv you learned how dishes should be washed 
and the sink kept clean. You can do the dishes that 
way, and not leave kettles to soak overnight, or 
scraps in the sink strainer to sour, or stale food in 
the refrigerator. You can keep the faucets polished 
bright, and the dishpan clean and shining, and the 
woodwork around the sink as white as soap and 
scouring can make it. Sometimes mother is so busy 
that it is hard for her to find time to scour the stove 
and scrub out all the corners of the refrigerator as 
often as she would like to do, and she will be glad 
to have you offer to help. 

All these things do not sound hard to do, and they 
do not take much time, but they make a great deal 
of difference in the happiness and health of the home. 

Cleanliness in the school. In the schoolhouse most 
of the arrangements for light, ventilation, and clean- 
liness are made by the teacher, the school doctor and 
nurse, and the janitor; yet there are several things 
the children can do to help. 

For instance, it is much easier for the teacher to 
keep the schoolroom properly ventilated if the chil- 
dren sitting in parts of it that are not getting enough 



HOW CHILDREN CAN HELP 285 

fresh air will report the fact to her pleasantly and 
courteously and ask to have a window open near 
them. Again, if the light is too dull or too dazzling, 
don't hesitate to let your teacher know it, and she 
will be glad to arrange the light for you, or let you 
change your seat, or, if the lighting condition is very 
bad, to report it to the janitor or the school board. 
Or if you have trouble hearing, you should report 
that to her also, and she will see that the difficulty is 
corrected. You should also report to her if you do 
not feel well — if your throat is sore, or your head 
aches, or you feel hot and feverish. Perhaps by do- 
ing so you may save other children in your class 
from catching some infection from you. 

Another thing you can do is to be quiet about the 
school halls. You can make a great deal of differ- 
ence in the comfort of other people by the way in 
which you come in at the front door, walk through 
the halls, and avoid banging doors, shouting, or loud 
talking. 

The condition of the toilet-rooms, cloak-rooms, 
and rest-rooms depends on you. The plumber may 
put in the most modern sanitary conveniences, and 
the janitor and matron may do the best they can to 
keep them clean and tidy, but the personal care- 
fulness of the children who use them is what really 
keeps them in healthful condition. You can keep 
from throwing apple-peelings, papers, and scraps of 
sandwiches about when you eat your luncheon. You 
can pick up trash that other people have been care- 



286 COMMUNITY HYGIENE 

less enough to leave, and call their attention politely 
to the need of everybody's helping to keep the school- 
building attractive. If there is not a waste-basket or 
scrap-can in which trash can be put, you can ask the 
janitor pleasantly and courteously for one, and you 
can help to see that it is used properly. 

Another thing that largely depends on you is the 
condition of the paint and kalsomine on the walls of 
your schoolroom and in the halls. You like to have 
pictures, flowers, and aquariums to make attractive 
the room where you spend most of your day; but 
you cannot make it look really well if the walls 
are scratched, the plaster is broken, and the paint 
marred. 

The school health society. Children can do so 
much to help keep the school-buildings, rooms, and 
playgrounds in healthful condition that some schools 
now are organizing children's health societies which 
meet once a week to discuss the conditions of the 
building and grounds and appoint committees to 
look after them. One committee has charge of the 
playground; another, of the basement; another, of 
the halls and stairways; another, of the toilets, and 
so on. Sometimes one child is appointed health offi- 
cer of the school for a week or a month, and he or she 
oversees these committees and the care of the build- 
ing and grounds in general. 

If the committees find that any child is untidy or 
careless about the building, or if any bad condition 
is found in the basement, playgrounds, or shops, 




Courtesy Consumers' League, N.J". 

RIGHT AND WRONG KINDS OF LAUNDRIES 



288 COMMUNITY HYGIENE 

they report it to the health officer. He reasons with 
the offender, explains tactfully that such bad con- 
duct is hurting the whole school, and tries to make 
him see the need for "team-work" in making the 
school a healthful place. If this does not make the 
offender do better, the health officer reports the mat- 
ter to the next meeting of the health society, and 
action is taken by the school as a whole. Sometimes 
if the case is sufficiently important, a court is organ- 
ized and a regular trial held, with judge, jury, and 
witnesses. 

Of course, such an organization must be careful 
not to interfere with the rules of the teachers and the 
sanitary officers of the school board. If tact and 
courtesy are used, it becomes one of the best possible 
helpers of the teachers and school board. 

In the broader community. Outside of the home 
and the school, children can also make themselves 
a help to the community, or by careless and insani- 
tary habits can add to the difficulties of the officers 
of the board of health. 

Take the question of pure food. No matter how 
many or how active the city food inspectors may 
be, they cannot possibly be everywhere at once. It 
helps them greatly if children notice where dirty or 
decaying fruits, vegetables, or meats are exposed for 
sale, or hawked from hucksters' carts, and report the 
offenders. In your report you should give the name 
of the store, its street number, and a list of the bad 
fruits or vegetables or meats that you saw. If you 



HOW CHILDREN CAN HELP 289 

are reporting a huckster's cart, take down his license 
number, which is on the side of the wagon. If you 
have a pencil and a piece of paper, it is better to 
write all these things down at once, so that you can 
be sure you are right. Report the case to your fam- 
ily, or to some policeman, or to the health depart- 
ment itself. Your father or mother or teacher will 
help you write your letter to the health department. 

The most useful service children can render to the 
community, however, is in keeping streets and alleys 
clean. A corps of volunteer inspectors composed of 
school-children can do more than grown-up inspec- 
tors can. There are many places where a health offi- 
cer seldom goes unless his attention is particularly 
called to them; but children go everywhere. If they 
get into the habit of seeing that back alleys, barn- 
yards, and vacant lots are kept clean, and of report- 
ing them to the police or health department when 
they are in bad condition, it will not be long until 
the neighborhood and perhaps the town has a thor- 
ough cleaning-up. Of course, this inspection must 
be done carefully and tactfully. 

Park and playground cleanliness. One of the rea- 
sons why it took so long to get the city to throw 
open its parks and public gardens to children as 
play places was that the city officials did not believe 
children would treat them properly. Children, they 
thought, would break the branches of expensive 
shrubs, trample carefully tended flower-beds, kick 
holes in the sod, and throw papers and trash on the 



290 COMMUNITY HYGIENE 

walks. It is not too much to say that most of a 
park's attractiveness and most of the pride which 
the community takes in its park systems depend on 
the way they are used and kept by children. 

Most children are careful of the city's property, 
and understand that when they go to a park, they 
are the guests of the city and have no more right to 
damage it than they have to damage a neighbor's 
garden or grounds. Unfortunately, there are some 
few children who do not understand this, just as 
some children in school take no pride in keeping 
the schoolroom and playground clean. 

One of the things you can do to make your com- 
munity attractive and healthful is to use the park 
properly whenever you play there, and to try to get 
other children to do the same. If you take a pride 
in the cleanliness and order of your park playground 
and wading or swimming pool, and if you will re- 
port to the park police any one — child or grown-up 
— whom you see abusing the hospitality of the city 
by ill-treating its property, you will do a real service. 

As we have seen, community hygiene deals with 
common, simple, ordinary things. Cleanliness, or- 
derliness, wholesome living — these make us strong 
and healthy and our community a pleasant place in 
which to live. If we will always do the things that 
make us well and happy, and never do anything 
that might make us or other people sick, uncomfor- 
table, or unhappy, we shall have a far better com- 
munity and far better citizens than we have now. 







1 






SETTING-UP EXERCISES 



GEORGE J. FISHER, M.D. 

Secretary, Physical Department International Committee 
Young Men's Christian Association 



i'7! 





Exercise i 

Position: Heels together, arms down 
and at sides, palms in. 

Movement: Swing arms sideways, 
upward to vertical, and return. 



Exercise 2 
Same as Exercise 1, except thai 
arms are swung forward, upward to 
vertical. 



SETTING-UP EXERCISES 



1 From the Official Handbook for Boys, Boy Scouts of America. 
Used by special permission 



SETTING-UP EXERCISES 



292a 




Exercise 3 Exercise 4 

Position: Arms extended to Position: Arms at side, horizontal, back 

side horizontal. slightly arched. 

Movement: Swing forward and Movement: Circle arms backward. 

return. 

(Emphasis upon backward 

movement.) 





Exercise 5 

Position: Forearms flexed at side 
Of chest. 

Movement: Thrust arms forward 
ind return. 



Exercise 6 

Position : Arms at front, horizontal, 
forearms flexed, fingers on shoulders. 

Movement: Swing backward to 
side, horizontal in position. 



SETTING-UP EXERCISES 



292b COMMUNITY HYGIENE 

IS n 



Exercise 7 
Position : Same as 
Exercise 6» 

Movement : Swing 
downward, forward, 
bringing arms beyond 
sides of body. Rise 
on toes with end of 
backward swing. 



Exercise 8a 

Position : Arms at 

vertical, thumbs 

locked, head fixed 

between arms. 




Exercise 86 
Movement : Bend 
forward as far as pos- 
sible, without bend- 
ing knees, and return. 



O^ 




Exercise go 
Position: Arms at vertical. 
Repeat exercise 8b. 

SETTING-UP EXERCISES 



Exercise 96 

Movement : Arm circles, downward, 

inward, across chest. Reverse th$ 

movement. 



SETTING-UP EXERCISES 



292c 





<-5>» 



Exercise 10 
Position: Hands on 

hips. 

Movement: Forward 

bend. 



Exercise ii 
Position: Same as 



Exercise 10. 

Movement : 
ward bend. 



Back- 



EXERCISE 12 

Position: Same as 
Exercise 10. 

Movement : Side- 
ward bend, right and 
left. 






Exercise 13 
Position: Same as 

Exercise 10. 

Movement : Rotate 

body at waist. 



Exercise 14 
Position: Same as 
Exercise 10. 

Movement: Raise 
high on toes. 

(Hold shoulders 

back firmly.) 

SETTING-UP EXERCISES 



Exercise 15 
Position: Same as 

Exercise 10. 
Movement : 

knee bend. 



Full 



QUESTIONS 

CHAPTER I 

What does it mean "to be healthy "? Why is it wrong to be sick, 
if you can avoid it? Mention some things you like to do when you 
are well and strong, but do not like to do when you are sick. What 
must you do to be healthy? How can you make work a pleasure? 
What are some of the things that are necessary to health that we like 
to do? Mention some unwholesome things that are sometimes diffi- 
cult to avoid. How may you avoid worry about your health? What 
is meant by calling "health and happiness first cousins"? What be- 
sides machinery, looms, mills, and factories have "money value"? 
Name fourteen things that make a nation wealthy. Which of these 
things is most important? What is the "money value" of your own 
life? Mention some ways in which the community is protecting the 
health of the people. Whom besides yourself is the State interested to 
keep healthy? How is the health of workers protected? Mention one 
way to prevent poverty in your own family and in the community. 
How can you help to make this world a comfortable and happy place 
in which to live? 

For community study 

How much does it cost to have the doctor make a visit to your 
house? How much does it cost to have a tooth filled? How much 
does a toothbrush cost? Find out one thing that is done in your home 
to protect the health of the family. Find out one thing that is done by 
the community in which you live to protect the health of all the 
people. 

CHAPTER II 

What are the four causes of health? How much longer do people 
live to-day than they did one hundred years ago? Why do they live 
longer now? What is one way of finding out whether or not a thing is 
good for you? What is the "Panama Canal Zone"? Where is it? 
What were the health conditions there when the United States began 
to dig the canal? What did General Gorgas do to protect the health of 



29 6 QUESTIONS 

For community study 

Visit the nearest meat-market and find out how the meat is kept 
from spoiling. How does your grocer or milkman keep his milk? 
Which of the suggestions for the care of food can you help to carry 
out in your home? 

CHAPTER VI 

What makes a cellar a bad place in which to live? Why is it well 
to have a cellar under a house? Describe the old-fashioned cellar re- 
ferred to in the text, or, better still, describe a similar one with which 
you are acquainted. How does the modern cellar differ from the old- 
fashioned one? Why should not moist foods be kept in the cellar? 
Where should moist foods be stored? Why should not milk, butter, 
and cheese be kept in the cellar? Where should milk be kept? Where 
should fruit and vegetables be stored? Describe a proper storage- 
room in the cellar. What foods may properly be stored there? What 
should not be stored there? Why? "Flora" means plants and 
"fauna" means animals. What plants lived in the old-fashioned 
cellar? What animals lived there? What harm do rats and mice do? 
How would a board of health build a first-class cellar? What is said 
about draining a cellar? What is one cause of chilblains? 

For community study 

What cellar that you know of is most like the cellar that a board of 
health would build? In what particulars could your own cellar be 
improved? What can you do to improve it? 

CHAPTER VII 

Why must you keep on cleaning yourself and your home? What 
is the best way to make cleaning a pleasure? What are the two quali- 
ties of a good floor? How may these qualities be secured? What set- 
tles on the floor from the air? What is the danger in dry-sweeping 
with a broom? What is the best way of removing dirt from the floor? 
How should the windows be washed? Why should soap and hot water 
not be used when you clean paint? What is the best way to wash 
paint? How were clothes washed in earlier days? Why is water so 
useful as a cleanser? What kind of dirt is not affected by water? Of 
what is soap made? What else will dissolve grease besides soap? Why 
should you be careful not to use very much soda, potash, or ammonia? 



QUESTIONS 297 

What is said about ammonia? Describe the modern way of washing 
clothes. What two advantages come from drying clothes out of doors? 
What is meant by "bluing"? What is the use of it? What is the 
health value of ironing? What is starching? What is meant by 
"bleaching"? What two things happen when a piece of cloth is 
bleached? In what two ways may cloth be bleached? 

For community study 

When the light is streaming into a room through the window you 
may see the particles of dust floating in the air. How may you help 
diminish the amount of this floating dirt in your own home when you 
clean the floors? When you "dust" the furniture and woodwork? 
How is the dust kept from rising in the air when the janitor of your 
school cleans the floor? Which is better to use as a "duster," a feather 
brush or a damp cloth? Why is it a good plan frequently to hang the 
clothes you wear in the open air? 



CHAPTER VIII 

What is necessary before one can have a bathroom? From what 
three sources may water be obtained where there is no town or city 
supply? What is the advantage and disadvantage of a windmill for 
pumping water? What power other than wind may be used for pump- 
ing? What are some of the advantages of a shower bath? What are 
some of the advantages of a tub bath? What is the effect of bathing 
in hot water? Why should hot baths be taken at night? Mention 
three benefits that come from a daily morning bath in cold water? 
How cold should the water be? Of what use is a brush when one is 
bathing? Of what use to the skin is powder? Of what use is cold 
cream? What is the best kind of oil for the skin? What is the effect 
on the skin of too much rubbing? Of what are cold creams made? If 
your skin needs to be improved with powder and cream, what is the 
reason? What is the best way to get a good complexion? How may 
the scalp be kept healthy? Can salves, tonics, and "hair restorers" 
improve the condition of the hair? What is the best way to keep the 
hair in good condition? What kind of a towel is best to use after a 
bath? What is said about the care of your bath-towel? Why should 
every one have an individual towel? How is the internal surface of the 
body bathed? What sometimes prevents the proper cleansing action 
of the water we drink and of the internal secretions? 



298 QUESTIONS 

For community study 

Who in your neighborhood pumps water to his house with a wind- 
mill? Who does it with a gasoline engine? How is water supplied to 
your house? Do you take a cold bath every morning? Do you enjoy 
it? If you do not enjoy it, what is the probable reason? 

CHAPTER IX 

The first paragraph mentions four things that man has been able 
to do by the use of fire that he could not do before its discovery. 
What are they? What is meant by the expression "the fire magic 
made us citizens of the world"? Describe an old-fashioned fireplace 
and how it worked. How can we always get fresh air into our home? 
Draw a diagram of a window opened to let out hot air and to let in 
cold air, indicating by arrows how the air moves. What advantages 
has a furnace compared with a stove? What advantages has steam or 
hot-water heating compared with hot-air heating? Of what advan- 
tage is it to have a warm bedroom? What disadvantage is there in 
steam and hot-water heating from the standpoint of ventilation? 

For community study 

Draw a diagram of a two-story house showing how each room may 
be warmed by a hot-air furnace. Indicate by arrows the movement 
of hot air. (If your own house is heated by a furnace, draw a diagram 
showing the furnace and its cold- and hot-air flues.) 

CHAPTER X 

Why is it necessary to have an abundance of fresh air in our bed- 
room at night? What is one of the purposes of sleep? When you 
breathe through the lungs, what happens? When you breathe through 
the skin, what happens? In order to allow the skin to breathe prop- 
erly at night, what kind of nightclothes and bed-coverings should 
you use? What is a "draft"? Why are drafts across the face par- 
ticularly healthful at night? What effect have drafts upon the skin? 
Why should you sleep between sheets? Why should sheets be aired 
daily and washed frequently? Why is wool a good material of which 
to make blankets? Name some substitutes for wool. How large 
should a pillow be? Of what material should it be made? If you were 



QUESTIONS 299 

buying a mattress, what qualities would you look for in it? Describe 
a model bedroom, referring to location and number of windows, kind 
of shades, wall-paper, pictures, location of bed. Why is a north room 
not the best for a bedroom? What can you say about the proper care 
of your bed and bedroom? 



For community study 

Compare your own bedroom with the model one described in this 
chapter. Is there anything you can do to make your room more like 
the model? Do you sleep with one or more windows open? Do you 
air your bedding daily before making the bed? Do you give your 
skin an air bath daily? 



CHAPTER XI 

Suppose you were planning to build a house. Where would you put 
the living-room? How large would you make it? How many windows 
would it have? Describe its furnishing. How would you make it 
"cozy"? Describe your favorite chair-. Are stiff straight chairs 
desirable in a living-room? What are tables for in a living-room? 
How many should there be? Why is a low bookcase better than a 
very high one? Why are rugs on a hard-wood or painted floor better 
than a carpet? In selecting rugs for the living-room, what size and 
colors will you choose? What objection is there to a highly polished 
floor? How nearly do you follow the directions given in the para- 
graph on sweeping and dusting when you help sweep and dust the 
living-room at home? What is the best kind of woodwork for a living- 
room? What is the best kind and the most pleasing color and design 
for a living-room wall-paper? Of what use are curtains, shutters, and 
blinds in a modern living-room? What kind of curtains, shutters, and 
blinds will defeat their real purpose? What is a living-room for? How 
can you make it serve its purpose? What are the "business hours" 
in the kitchen? Why is a play-room desirable? Draw a plan of the 
sort of play-room you would like, showing the different pieces of furni- 
ture and the places where your different games would be. Provide in 
this play-room for your brothers and sisters. In what part of the 
house should the play-room be located? What should a workshop 
contain? Where should it be located? What is said about the 
work bench? About lighting the bench? 



3 oo QUESTIONS 

For community study 

When the author of this book says that the living-room "should 
not be too tidy," does he mean that it should be in disorder? If the 
living-room is to be a real living-room, every one in the family must 
help make it so. What can you do to help? If you have a work- 
shop or a doll's house at home describe it. How would you like to 
improve it? If you do not have one, describe the best one you 
have seen. 

CHAPTER XII 

Why is a porch that is big enough for a living-room "the healthiest 
room in the house" for grown people? For children? Describe the 
old-fashioned porch. Describe the modern porch. To what uses may 
a porch be put? What kind of furnishing is desirable? What part of 
the porch is it desirable to screen? Of what use are movable shades? 
Of what materials are they made? What is a "sleeping-porch"? 
How should it be built? For whom is it specially desirable? Why is it 
well to have the back porch large and roomy? Why is it well to have 
it screened? 

For community study 

Describe any sleeping-porch that you personally know. Who sleeps 
there? What do they do in stormy weather? What do the people 
who use the porch say about its advantages? Where could a sleeping- 
porch be built on your house? 

CHAPTER XIII 

Of what use is a barn to children? What useful training may a boy 
get in a barn? What are some of the dangers connected with playing 
in a barn? How should the stalls be cleaned? What kind of floors 
should be laid in stables? How should the drainage of the stalls be 
provided for? Describe the proper way to take care of a hen- and 
chicken-house. Describe a modern pigpen. What should be done to 
keep the pigs healthy and to prevent the pen from becoming a danger 
to the health of the people who live near? What is meant by calling 
the manure-heap a "good servant"? What double profit comes from 
properly caring for the manure-heap? How should the barnyard be 
kept so that it will be healthful for man and beast? When does the 
manure-heap become a "bad master"? 



QUESTIONS 301 

For community study 

The barn and outbuildings are the peculiar care of boys, as the 
kitchen, bedroom, etc., are for girls. Let the boys, therefore, take the 
lead in studying and reporting on the condition and care of barns and 
outbuildings at home and in the neighborhood. Let them suggest how 
they may improve conditions for which they are more or less respon- 
sible. 

CHAPTER XIV 

Why are the garden and grounds about the house important? To 
make them a healthful setting for the home, what should be their size 
and how should they be kept? What is the most satisfactory way of 
beautifying the front yard? What objections are there to having trees 
and tall shrubs close to the house? What is the best use that can be 
made of a back yard? What should be done with the empty cans and 
refuse? Why should garbage be kept in a covered can? Why should 
the garbage-can be washed out regularly? What three ways of dis- 
posing of garbage are mentioned? Explain how to protect a well of 
drinking-water from the refuse on the surface of the ground: from 
the surface water. Why is it necessary regularly to inspect and clean 
out a well? Why are wells in villages and cities particularly dangerous? 

For community study 

Are the grounds about your school well kept? How could they be 
improved? What can you do to improve them? If you have a well at 
home from which you draw drinking-water, find out which of the con- 
ditions for protecting it mentioned in this chapter are provided. If 
you have no well at home, make a study of one in the neighborhood 
to determine whether or not the water in it is properly protected. 



CHAPTER XV 

In what kind of places did the earliest men live? Describe the earli- 
est houses that were built. What is the advantage of having windows 
on two sides of a schoolroom? On which sides should they be? From 
what direction ought light to strike your book when you are reading? 
On which sides of the room ought the blackboards to be? Of what use 
are window shades? Why should the ceiling of a schoolroom be at 
least ten feet high? Why should it not be over fifteen feet high ? What 



3 o2 QUESTIONS 

is the common cause of deafness in school-children? How may it be 
remedied? If you are inclined to breathe through your mouth, what 
is the probable reason? What causes the air to become impure? How 
can you tell when the air needs to be changed? Why is it well to exer- 
cise while the air is being changed? 



For community study 

Is the area of all the windows in your schoolroom equal to one 
fifth the area of the floor? Do you have difficulty in seeing the writing 
on the blackboards? Can you hear easily all that is said in the school- 
room? Do you know of any building where the windows have been 
enlarged recently? Is there a house in your neighborhood where the 
old-fashioned small panes of glass still remain? 



CHAPTER XVI 

Why do we need warmer houses than the people did who lived long 
ago? Why do we need a warmer room to sit in than we do to play in? 
Which is more harmful, to sit in a room that is a little too cool or in 
one that is a little too warm? Which is more important, warmth or 
air? Why is it so difficult in winter to keep the right temperature and 
at the same time have the air fresh? What is meant by "second- 
hand air"? What is first-hand air? What is the only way to get first- 
hand air into a room? What is the best way to destroy germs in a 
room? How are the best hospitals heated and ventilated? Describe 
an "open-window classroom." How do the pupils dress? How do the 
"open-window classrooms" differ from the "open-air classrooms"? 
For what kind of children are the open-air classrooms intended? How 
are the children dressed in these rooms? What is said of the progress 
made by the children in such rooms? 

For community study 

Could your schoolroom be turned into an "open-window" class- 
room? What would need to be done? Explain to your parents the 
idea of the "open-window" classroom, how you would dress, and the 
probable result in your school progress, and ask them if they are will- 
ing to have your teacher try the plan. Would you yourself like to try 
it? 



QUESTIONS 303 

CHAPTER XVII 

How can you do all your school work well and yet not sit still for a 
long time? What is the best way to keep the back straight and the 
shoulders square? How has it been proved that the muscles get tired 
before the nerves do? What, then, is a good way to rest the nerves? 
If your eyes get tired while you are reading, how can you rest them? 
How can. you do the largest amount of work in a day? Mention four 
reasons why blackboards should be provided and used in school. 
Mention two drawbacks to the usefulness of blackboards. How can 
each drawback be diminished? 

For community study 

Find out whether or not your own chair and desk fit you by apply- 
ing the tests given in this chapter. Are there any blackboards in your 
schoolroom between windows? Do you notice that it strains your 
eyes to read much from these boards? When you cannot see the 
writing on the blackboards easily, what ought you to do? 

CHAPTER XVIII 

Why is it difficult to keep a schoolroom floor in good repair? Why 
does a poor floor make a dusty schoolroom? What is done in some 
schools to keep the dust from rising from the floor? What are the ob- 
jections to stone and cement floors? How may old floors be improved? 
Of what material should stairs be made? Why should they be well 
lighted and free from sharp turns? How should the doors open? 
What is the peculiar danger in a dark and dirty cellar under a school- 
house? 

For community study 

How may school-children help to keep the schoolhouse floors free 
from unnecessary dirt? How may the janitor help to keep the school- 
house free from unnecessary dust? Are the stairs in your schoolhouse 
well lighted, easy to walk over, and free from dangerous landings and 
turns? 

CHAPTER XIX 

What objections are there to basement toilets? Where are toilets 
properly located? Mention four requisites of a good school toilet. 



30 4 QUESTIONS 

What is said of "deodorizers"? What should be the school standard 
regarding toilets? What is said about school baths? Why should the 
cloak-room be well lighted, warmed, and ventilated? What is a rest- 
room for? What children may need to use it? 

For community study 

Write a composition on the subject, "The Cloak-Room in Our 
School." Describe it as it is and state in what particulars it should 
be changed. 

CHAPTER XX 

Why is the playground the best part of the school plant? How large 
are the playgrounds connected with some recently built schools? 
How does this compare with the size of your school yard? What are 
some of the important lessons we may learn at play? What is said 
about trying to work when you are tired? What are the conditions 
for good brain work? What is the trouble when you get tired? What 
two ways are there of getting rested ? What is said of learning with our 
eyes, ears, and memories alone, and of learning also with our hands, 
feet, and muscles? If we are to play much out of doors in wet weather, 
in what condition ought the ground to be? What is the advantage of 
a large open shed? What is said regarding the importance of knowing 
how to swim? 

For community study 

What games train the eye to be quick and accurate? What 
games train the hand? What games train the judgment? What 
games train us to control our temper? Try the following experiment 
on yourself: The next time you have a home lesson to prepare, do it 
when you are feeling rested and see if you can do it in half the time 
you take when you feel tired or sleepy. 

CHAPTER XXI 

What kind of "grit" is liable to get into the human machine? 
What is liable to happen if we neglect infectious diseases when they 
first appear? Where is the best place for us, if we are sick even 
slightly? If we have an infectious disease, for whom should we be 
interested besides ourselves? Of what use is a school doctor? What 
does a school nurse do? Describe a "vacation" school in the country. 
How will your eyes and ears warn you that you need to rest? What 



QUESTIONS 305 

warnings of approaching illness sometimes appear in the nose and 
throat? What is the best way to ward off illness? If we are ill, we 
should keep away from others. If others are ill, what attitude should 
we take toward them? Does this attitude mean that we are indiffer- 
ent to them? How may you avoid taking infectious diseases? Men- 
tion four things that you should not do, if you wish to avoid infectious 
diseases. 

For community study 

What are some of the things that you are accustomed to do thought- 
lessly that you will now avoid doing after reading thjs chapter? What 
are some of the things you notice older people doing that you now 
realize may put "grit" into their "machines"? 

CHAPTER XXII 

Why were pure-food laws not needed in former times? What is the 
most common cause of food decay? Why is there less danger in eating 
food that is fresh than in eating that which is old? Why are inspec- 
tors needed to look after food that is transported long distances? 
What precautions are taken by many steamship and railroad com- 
panies to protect food? What is the advantage of cold-storage ware- 
houses? How have these been misused? What is the objection to us- 
ing cellars for cold-storage purposes? What is said of the work of food 
inspectors in wholesale stores? In retail stores? How is food being 
put up to protect it from dirt and germs? Why do food inspectors not 
visit your home? What is meant by the term food adulteration? Men- 
tion some foods that are easily adulterated. Name some adulterations 
that are not harmful. Name some that are harmful. 

For community study 

Make a collection of some of the labels that come on canned, bot- 
tled, and boxed food bought for home use. What do the labels say 
about substances put in to preserve them? Why is it important to get 
into the habit of reading these labels? 

CHAPTER XXIII 

How does water get most of its impurities? What is the objection 
to having a well near a number of houses? What is an artesian well? 



306 QUESTIONS 

From what is the name artesian taken? Why is the water taken from 
an artesian well more likely to be pure than that taken from a shallow 
well? Why is it dangerous for a city to take its water from a near-by 
river? Cities are now generally supplied with water from distant 
reservoirs or from a filtering plant. Explain each method. How is the 
cost of supplying a city with pure water met? How is typhoid fever 
spread? What besides germs may make water impure and dangerous 
to drink? What does boiling do to water? What does it not do? 
What is said about filters? 



For community study 

Where does the water come from that you drink at school? If it 
comes from a well, has it been tested and pronounced fit to drink? 
Is the well properly protected from surface drainage and from dirt? 
When was it last cleaned out? Where does the water come from that 
you drink at home? Do you use a filter at home? If you use a filter 
has it been called a good one by your family physician or the board 
of health? How many cases of typhoid fever were there in your town 
last year? 

CHAPTER XXIV 

Are unpleasant smells injurious to health? How do bacteria or 
germs of decay purify waste material? What is the work of soil bac- 
teria? What would happen if there should be no soil bacteria? How do 
farmers help soil bacteria to grow? What is there in water that tends 
to purify it? Why, then, cannot cities pour all their sewage into near- 
by rivers and ponds? What is likely to happen if much sewage is sent 
into the sea near large cities? Describe the chemical-tank method of 
"sweetening" sewage. Describe the septic-tank method. What is the 
objection to the old-fashioned cesspool? Why should the sewer pipe 
leading from a house be small? What is a sewer-gas trap? What is this 
trap for? Describe a proper kind of garbage-can. Describe the proc- 
ess of disposing of garbage by means of a reduction plant. By means 
of an incinerator. By burying it in trenches. 

For community study 

How is sewage disposed of in your town or city? How is garbage 
disposed of? 



QUESTIONS 307 

CHAPTER XXV 

Of what is dust in the country composed? Of what is dust in the 
city composed? How does dust get into our systems? Mention some 
kinds of work that are particularly unhealthful because of dust. How 
is dust kept down in the streets and roadways by sprinkling? By 
different kinds of pavement? Why do roads and streets make good 
playgrounds? Why are they undesirable for use as playgrounds? 

For community study 

How is dust kept down in the streets or roads of your town or city? 
Are there factories in your neighborhood that give off objectionable 
dust? In choosing one's work, what is one of the things that should be 
considered? 

CHAPTER XXVI 

In what particulars are cities like animals? Why must a city have 
"lungs"? What was the purpose of the "park" in former days? 
What is its purpose to-day? What facilities for play and amusement 
are now provided in parks? What is said about some parks in foreign 
countries? What is said about the public "country clubs" in such 
cities as Chicago? Where are picture galleries and museums often 
placed? Why is the park an appropriate place for these institutions? 

For community study 

Is there a park in your neighborhood? Is there need of one? Men- 
tion some of the interesting things you have seen in any park you 
have visited. What is our duty when we visit a park that is provided 
by the community for our health and enjoyment? 



CHAPTER XXVII 

What things are necessary to make a home comfortable and health- 
ful to live in? Which of these things is often lacking in the crowded 
parts of large cities? What do building and housing laws require in 
most cities? Why are such laws needed? How did the unhealthful 
conditions in large cities come about? How does the high price of 
land help to remedy these conditions? How are they remedied in 



308 QUESTIONS 

many European cities? In many cities what changes are being made 
in the streets? What is said about boulevards, parks, etc.? What 
about the location of factories and freight yards? 

For community study 

Are there any overcrowded sections in your town or city? Are there 
any streets that are too narrow to accommodate the traffic that uses 
them? Does the town or city in which you live have any building or 
housing laws? 

CHAPTER XXVIII 

What are the greatest carriers and spreaders of disease germs? 
What is said of the struggle between human beings and insects? 
Name some insects that kill a great many people. Name the helpful 
insects. What damage do birds do? What service do they render? 
What is said about swallows? What is the relation between worms 
and flying insects? What is the best way to kill flying insects? De- 
scribe three ways in which mosquitoes may be destroyed. How may a 
town or a city be rid of mosquitoes? How many kinds of flies are 
there? Which kind is most troublesome to human beings? What do 
flies indicate? How, then, can we be rid of them? Describe the con- 
ditions under which the fly hatches. What three ways are there of 
preventing flies from hatching in manure piles? Where can you get 
further information about flies? What two kinds of damage do rats 
and mice do? How can we get rid of rats and mice? 

For community study 

What measures are taken at home to protect the family from flies 
and mosquitoes? Are there any breeding-places in your yard or near 
your house in which these pests can breed? Is your town doing any- 
thing to limit their breeding? Is your State doing anything to limit 
it? What can you do at home and at school to limit it? 



CHAPTER XXIX 

Why must people in crowded cities take greater care to guard 
against infectious diseases than people in country districts? How does 
yellow fever spread? How has it been stamped out? What are the 
four things mentioned as the best disease-preventers? What are 



QUESTIONS 309 

quarantine stations? How are people warned that a person has an in- 
fectious disease in a certain house? What is meant by quarantining a 
house? What is vacciv-aiion? What has been the result in some Euro- 
pean countries of compelling every one to be vaccinated against 
smallpox? When the vaccination takes, what has happened? If you 
have an infectious disease and recover, why are you not likely to have 
that disease again? What insects help to spread disease? What 
animals help to spread disease? What is said about tramps? 

For community study 

Is every child in your school required by law to be vaccinated? 
When were you last vaccinated? Did it "take"? When you see a 
card on a door stating that a person in the house has an infectious 
disease, what should you do? When you are "quarantined" because 
of illness at home, why should you avoid playing with other children? 
Why should you avoid playing with children who are quarantined? 

CHAPTER XXX 

How may heart disease be prevented? Is tuberculosis increasing or 
decreasing in this country? In what ways do you think that you can 
help fight the Great White Plague in the coming years? Do you think 
that it is more important to keep away from a person who has pneu- 
monia than from a person who has chickenpox? Why? Can we do 
anything to avoid kidney disease? Mention a few ways. What causes 
apoplexy? Give several reasons why health authorities should insist 
on clean milk, water, and food. 

For community study 

Find out as much as you can about what is being done to reduce 
the amount of tuberculosis in your community. How many babies 
under one year of age died in your community during the last five 
years? (Infant mortality is the number of deaths of babies under 
one year of age for each thousand babies born during any given year. 
To estimate it, divide the number of births for the year by one thou- 
sand, and divide the number of deaths of babies under one year of 
age by the quotient.) New York State recently had an infant mortal- 
ity of 97. How does your community compare with this? (If your 
community has less than 100,000 population, fairer results will be 
obtained by taking the average for the last five years.) Do you 
think that good infant welfare work pays? Why? 



310 QUESTIONS 

CHAPTER XXXI 

What sort of a place was the factory of former days? How has the 
introduction of machinery helped to change these unhealthful con- 
ditions? What has caused manufacturers to take greater care of the 
people who work for them? What should you consider when you 
choose your life-work? Why have different kinds of education been 
introduced into schools? What is said about the results of shortening 
hours of labor? How are the best factories now built? Where are 
they built? What provision is now being made to protect workmen 
against accidents? What provisions are made to protect against fire? 
Against poisonous gases and other injurious products of manufac- 
ture? What are intelligent employers doing for the general health of 
their employees? 

For community study 

If a modern factory has been built in your neighborhood, compare 
it with an old-fashioned factory in respect to (a) the material of which 
it is built; (b) the amount of window space; (c) the protection of 
workers from machine accidents. Is. there a lunch-room in it for 
workers? Is it surrounded by ample grounds? 

CHAPTER XXXII 

What rules should you follow when you step from the sidewalk to 
cross a street? What four rules should be followed in getting on and 
off street-cars? What are the four "rules of the road" in this coun- 
try? What are the advantages of having well-lighted streets? What 
are the effects of the "smoke nuisance" on property? On health? 
How may the smoke nuisance be abated? 

For community study 

Do you yourself follow the rules set down in this chapter when you 
cross the street? When you get on and off street-cars? Is there a 
"smoke nuisance" in your town or city? What factories are respon- 
sible for it? 

CHAPTER XXXIII 

Who in the community can help most in making a clean, healthful, 
and beautiful town or city? Describe the most important thing you 
can do to make a healthy community. Describe five ways in which 
you can help make a healthful home. Describe four ways in which 
you can help make a healthful school. In what three ways can 
you help make your town or city healthful and beautiful? 



GLOSSARY 

Ac'id (as'id). A substance (usually sour-tasting) that neutralizes 
alkalies (usually with fizzing) and combines with other substances 
to form salts. 

A cous'tics (a koos'tiks). The science of arranging a building for 
the transmission of sound. 

Ad'e noid (ad'e noid). An enlargement of a gland in the back of the 
nose. 

\ dul'ter ate. To make impure by addition of a foreign or cheaper 
substance. 

M'co hoi. A colorless liquid formed by the fermentation of starch- 
sugars or certain other substances. It is highly inflammable and 
burns without smoke or waste; it is a stimulant and an antiseptic. 

Al'i men'ta ry ca nal'. The food tube, or digestive tube, extending 
from the lips and nose to the end of the rectum, including its 
branches and attachments. 

Al'ka li (al'ka li). A substance that neutralizes acids, forming salts. 
(See Acid.) It also combines with fats to form soaps. 

A noph'e les. A genus of mosquito whose bite is the means of infect- 
ing a human being with malaria. 

An'ti tox'in (an'ti tox'in). A substance which has the power of neu- 
tralizing poisons produced in the body by the bacteria of some 
disease. 

Ar'ter y (ar'ter 1). One of the branching blood vessels which carry 
the blood from the heart to the different parts of the body. 

Asth'ma (az'ma). A disease characterized by difficulty in breathing. 

Ba cil'lus (ba sil'lus). A large family of bacteria, some dangerous 
(as typhoid bacilli) and some helpful (as the soil bacilli). 

Bac te'ri um (bac te'ri um). A large group of tiny cell-like structures, 
millions of which may be found in a single drop of fluid. Some 
are harmful, producing disease, and some helpful, such as the 
soil bacteria. 

Bron chi'tis (bron ki'tls). Inflammation of the bronchial tubes. 

Bu bon'ic plague (bu bon'ic plag). A deadly infectious fever also 
known as " The Black Death." 

Car'bon di ox'ide (car'bon di ox'id). A heavy colorless gas, poison- 
ous and impossible to breathe. 

Ca rot'id arteries. The pair of arteries which may sometimes be 
noticed throbbing in the neck. 



3 i2 GLOSSARY 

Ca tarrh'(ka tar'). An acute inflammation of the membranes of the 
nose. 

Cell. The simplest form of living matter, with power to grow, re- 
produce itself, and with others of its kind build up a living fabric. 

Chol'er a (k5l'er a). Any one of a number of digestive diseases, such 
as Asiatic cholera, cholera infantum, etc. 

Chrys'a lis (kris'a lis). The pupa stage of certain insects, usually 
passed in a more or less hard case or shell. 

Clin'ic (klin'ik). An institution connected with a medical college or 
hospital where patients are treated without charge. 

Com mu'ni ty (kom mu'nit 1). A body of people having a common 
organization or interests, or living in the same place under com- 
mon laws. It may be used of a neighborhood, a town or city, a 
county, state, or nation. 

Con gest'ed (kon jest'ed). Overcrowded with population, used in 
speaking of a district. 

Con ta'gion (k8n ta'jiin). The transmission of a disease from one 
person to another by direct or indirect contact. 

Con tam'i nate. To soil, stain, or corrupt by contact. 

Crem'a to ry (krSm'a to ry). A furnace for burning rubbish or refuse. 

Crib. A heavy framework of logs or beams filled with stone or rubble 
and sunk in a lake or river to protect the city water intake pipe. 

Death-rate. The ratio of the number of deaths for a given period to 
the population. 

De o'dor iz'er (de o'der Iz'cr). A substance that destroys offensive 
odors. (See Disinfect.) 

Di ges' tion (dl jes'chun). The process of changing food in the ali- 
mentary canal into a form absorbable by the blood. 

Diph the'ri a (dif the'ri a). An acute infectious disease affecting the 
throat. 

Dis'in feet' (dfs'in f6kt')- To free from infectious or contagious mat- 
ter; to destroy germs and make harmless. 

Dys'en ter y (dis'en ter I). A disease of the large intestine. 

En 'to mol'o gy (en to mol'o ji), Department of. A department of the 
National Government devoted to the study of insect pests. 

Ep'i dem'ic (ep'i dem'ik). Any disease which, spreading widely, at- 
tacks many persons at the same time. 

E rup'tion (e rup'shun). A rash on the skin, as in measles. 

Er'y sip'e las (er'i sip'e las). An acute infectious disease of the skin. 

Fa tigue' (fa teg'). A condition in which the body cells are worn out 
faster than they build up, so that waste matter gathers in the 
system and poisons it. 



GLOSSARY 313 

Fau'na. The animals of a given place or region. 

Fer'men ta'tion (fer'men ta'shun). A chemical change in plant or 
animal substance, produced usually by the action of bacteria, 
in the process of which the substance is broken up and new sub- 
stances formed. 

Flo'ra (flo'ra). The plants of a given place or region. 

For'ma lin (for'ma lm). A liquid disinfectant. 

Germ.. The simplest form of life from which a living organism de- 
velops — a bacterium or bacillus. 

Ger'mi cide (jer'mi sid). A chemical compound used to kill bacteria 
or bacilli. 

Gland. A part, or organ, that has the power of making a secretion 
peculiar to itself. 

Hy'gi ene (hi'ji en). The science of preserving health. 
Hy'po der'mic (hi'po dur'mik). Pertaining to the parts under the 
skin. 

In cin'er a tor (in cin'er a, ter). A furnace for burning refuse or rub- 
bish. 

In fec'tion (in fek'shiin). Communication of a disease from one per- 
son or organism to another. 

In'flu en'za (in'floo en'za). A feverish infectious disease affecting 
the throat and the entire system. 

In oc'u late (in ok'u lat). To communicate a disease to a person or 
animal by inserting its virus in the skin or flesh. 

Ju'gu lar (joo'gu lar). A large vein in the neck. 

Lab'o ra to ry (lab'o ra to ri). The workroom of a chemist or sci- 
entist. 

Lar'va (lar'va). Any young insect from the time it hatches to the 
time when it goes into the chrysalis — a caterpillar or " worm." 

Mag'got (mag'St). The footless larva of any fly. 

Ma la'ri a (ma la'ri a). A feverish illness produced through the bite 

of the Anopheles mosquito. 
Mea'sles. A contagious feverish disease marked by an eruption of 

red spots. 
Mi'cro scope (mi'kro skop). An optical instrument for making an 

enlarged image of an object too small to be seen by the naked 

eye. 
Mus'ca do mes'ti ca (mus ka do mes'ti ka). The Latin name for 

the common house-fly. 



314 GLOSSARY. 

Ox'y gen (oks'I jen). A gaseous element in the air necessary to 
respiration. It occurs also in water and elsewhere. 

Pel lag'ra (pel lag'ra). A disease common in the Southern United 

States and other warm climates. 
Pneu mo'ni a (nil mo'ni a). Inflammation of the lungs. 
Pol lute' (pol lut')- To make foul, impure, or unclean. 
Pre serv'a tive (pre serv'a tiv). A substance having the power of 

preserving other substances from decay. 
Pu'tre fac'tion (pu'tre fak'shun). Act or process of becoming rotten. 

Rash. An eruption on the body. 

Sa li'va (sa ll'va). Secretion from the salivary glands: spittle. 

Se cre'tion (st kre'shun). Any substance separated from the blood 

by a gland and changed into a new form. 
Seep'age (sep'aj). The ooze, or liquids which pass through the soil 

and contaminate wells or water-supplies. 
Se'rum (se'rum). The watery portion of the blood. 
Sew'age (su'aj). Liquid refuse carried away from houses and fac- 
tories by drains. 
Sol'vent (sol'vent). A substance, usually liquid, having the power 

of dissolving something. 
Spores. Tiny grains of flowcrless plants which correspond to seeds. 
Steg'o my'i a (steg'o my'ya). The variety oi mosquito whose bite 

is the means oi infecting a human being with yellow fever. 
Ster'ile (ster'fl). Free from all reproductive spores or germs. 
Stim'u lus (stim'u lus). That which excites a temporary increase of 

vital action cither in the whole organism or in any of its parts. 
Sto mox'ys cal'ci trans (sto moks is' kal'si trans). The Latin name 

of the stable fly. 

Tem'per a ture. Degree of heat or cold. 

Tet'a nus (tet'a nils). Lockjaw. 

Ton'sil ll'tis (ton'sil li'tis). Inflammation of the tonsils. 

Tox'in (tSks'in). A poisonous product formed by harmful bacteria. 

Tu ber'cu lo'sis (tu ber'ku lo'sis). A disease producing tubercles 

in the internal organs, usually in the lungs. 
Ty'phoid (ti'foid). A contagious fever produced by a particular 

bacillus. 
Ty'phus (ti'fus). A contagious fever, marked by red spots. 

Vac'cine (vak'sm). The virus used to produce immunity from a dis- 
ease. 



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